Health Condition 1: G35- Multiple sclerosis
Conditions
Interventions
Intervention1: IMU-838: he IMP will be administered once daily as oral tablets.
On Day 1 of the MP, patients will receive a small bottle and large bottle. The small bottle will
contain 7 tablets of
Sponsors
Immunic AG
Eligibility
Inclusion criteria
Inclusion criteria: 1. Male or female patient (age =18 to =55 years). 2. Patients with an established diagnosis of MS according to 2017 McDonald Criteria. 3. Patients with RMS comprising of relapsing remitting MS (RRMS) and active secondary progressive MS, both defined according to Lublin criteria 1996 and 2014.a a Patients are eligible for this trial if their disease modifying treatment has failed due to efficacy, safety, or tolerability issues, if they have contraindications or no access to treatment, or if they refuse the offered MS treatment. 4. Active disease as defined by Lublin 2014 evidenced prior to Screening by: a. At least 2 relapses in the last 24 months before randomization, or b. At least 1 relapse in the last 12 months before randomization, or c. A positive Gd+ MRI scan (brain and/or spine) in the last 12 months prior to randomization. 5. EDSS score between 0 and 5.5 (inclusive) at SV1. 6. Female patients: a. must be of non-childbearing potential, ie, surgically sterilized (hysterectomy, bilateral salpingectomy, bilateral oophorectomy at least 6 weeks before SV1) or postmenopausal (where postmenopausal is defined as no menses for 12 months without an alternative medical cause), or b. if of childbearing potential, must have a negative pregnancy test at SV1 (blood test) and before the first IMP intake (Day 1 blood or urine test). They must agree not to attempt to become pregnant, must not donate ova, and must use a highly effective contraceptive method (see below) together with a barrier method between study consent and 30 days after the last intake of the IMP. c. highly effective forms of birth control are those with a failure rate less than 1% per year and include: i. oral, intravaginal, or transdermal combined (estrogen and progestogen containing) hormonal contraceptives associated with inhibition of ovulation. ii. oral, injectable, or implantable progestogen-only hormonal contraceptives associated with inhibition of ovulation. iii. intrauterine device or intrauterine hormone-releasing system. iv. bilateral tubal occlusion. v. vasectomized partner (ie, the patient’s male partner underwent effective surgical sterilization before the female patient entered the clinical study and is the sole sexual partner of the female patient during the clinical study). vi. sexual abstinence (acceptable only if it is the patient’s usual form of birth control/lifestyle choice; periodic abstinence [eg, calendar, ovulation, symptothermal, postovulation methods] and withdrawal are not acceptable methods of contraception). d. Barrier methods of contraception include: i. condom. ii. occlusive cap (diaphragm or cervical/vault caps) with spermicidal gel/film/cream/suppository. 7. Male patients must agree not to father a child or to donate sperm starting at SV1, throughout the clinical study, and for 30 days after the last intake of the IMP. Male patients must also: a. abstain from sexual intercourse with a female partner (acceptable only if it is the patient’s usual form of birth control/lifestyle choice), or b. use adequate barrier contraception during treatment with the IMP and until at least 30 days after the last intake of the IMP, and c. if they have a female partner of childbearing potential, the partner should use a highl
Exclusion criteria
Exclusion criteria: MS-related exclusion criteria: 1. Patients with non-active secondary progressive MS and primary progressive MS. 2. Any disease other than MS that may better explain the signs and symptoms, including history of complete transverse myelitis. 3. Clinical signs or presence of laboratory findings suggestive for neuromyelitis optica (NMO) spectrum disorders or myelin oligodendrocyte glycoprotein (MOG)-IgG-associated encephalomyelitis. 4. Any MRI finding, which puts in question the MS diagnosis, including but not limited to a longitudinally extensive spinal cord lesion. 5. History of malignancy of any organ system (other than localized basal cell carcinoma of the skin or adequately treated cervical cancer), treated or untreated, within the past 5 years, regardless of whether there is evidence full remission at the current time. 6. Any active and uncontrolled coexisting autoimmune disease, other than MS (except for type 1 diabetes mellitus and inflammatory bowel disease). 7. An MS relapse ending within 30 days before SV1 and/or during the Screening Period (until Day 1). 8. Any corticosteroid treatment for relapse given within 30 days before SV2. Therapy exclusion criteria: 9. Use of experimental/investigational drug (with the exception of COVID-19 vaccines approved by emergency use authorization) within 8 weeks or 5 times the respective half-life before the date of informed consent, whichever is longer, and throughout the duration of the study; and/or participation in drug clinical studies within 6 months prior to Screening. (For selected approved marketed products, if used as an investigational drug, exclusion criterion 11. applies). 10. Any previous treatment with: a. total lymphoid irradiation b. bone marrow transplantation c. stem cell transplantation d. cladribine, alemtuzumab, or belimumab, including their biosimilars 12. Any use of adrenocorticotrophic hormone or occasional use of systemic corticosteroids (oral or intravenous) 30 days before SV2. 13. Any use of the following concomitant medications is prohibited during Screening and throughout the duration of the study: a. any medication known to significantly increase urinary elimination of uric acid, in particular lesinurad, as well as uricosuric drugs such as probenecid b. treatments for any malignancy, in particular irinotecan, paclitaxel, tretinoin, bosutinib, sorafenib, enasidenib, erlotinib, regorafenib, pazopanib, and nilotinib c. any drug significantly restricting water diuresis, in particular vasopressin and vasopressin analogs Immune response exclusion criteria 14. Conditions (including previous organ transplant) requiring treatments negatively affecting the immune system. 15. Clinically significantly low lymphocyte and/or neutrophil count (Common Terminology Criteria for AEs Grade of 2 or higher), ie, lymphocyte count and/or neutrophil count 16. History of chronic systemic infections within 6 months before the date of informed consent, including but not limited to tuberculosis and human immunodeficiency virus (HIV). HIV infection that is undetectable within the prior 6 months is not an exclusion criterion. 17. Positive test for S
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Objective:Demonstrate the efficacy of IMU-838 versus placebo in adult patients with active RMS in delaying the occurrences of relapses based on time to first relapse. Endpoint:Time to first confirmed relapse, as determined by the INEC, relapse occurred after the start of treatment administration & before the end of the main period (EOMP) censored at a maximum of 72 weeks, Visit 8/EOMP Summary Statistics:Hazard ratio for relapse free survival between patients randomized to IMU-838 and placebo.Timepoint: 72 Weeks | — |
Secondary
| Measure | Time frame |
|---|---|
| Objective:To evaluate the effect of IMU-838 versus placebo on volume of new T2-lesions Variable/Endpoint:Changes in total volume of new T2-lesions from baseline (BL) magnetic resonance imaging (MRI) until Week 24 MRI Summary Statistics:Mean difference in the volume of new T2 lesions between IMU-838- & placebo-treated patients, on a logarithmic scaleTimepoint: Week 24 | — |
Countries
Albania, Algeria, Bulgaria, Colombia, Georgia, Germany, Greece, India, Jordan, Lebanon, Lithuania, Macedonia, Mexico, Montenegro, Poland, Republic of Moldova, Russian Federation, Spain, Ukraine, United States of America
Contacts
Public ContactAndreas Mühler
Worldwide Clinical Trials India Pvt. Ltd.
Outcome results
None listed