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Clinical Study to Evaluate the Efficacy, Safety, and Tolerability of ACT-128800 in Patients With Relapsing-remitting Multiple Sclerosis

Multicenter, Randomized, Double-blind, Placebo-controlled, Parallel-group, Dose-finding Study to Evaluate the Efficacy, Safety, and Tolerability of Three Doses of ACT-128800, an Oral S1P1 Receptor Agonist, Administered for Twenty-four Weeks in Patients With Relapsing-remitting Multiple Sclerosis

Status
Completed
Phases
Phase 2
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT01006265
Enrollment
464
Registered
2009-11-02
Start date
2009-10-01
Completion date
2011-07-01
Last updated
2025-03-30

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Multiple Sclerosis

Brief summary

This study will assess the efficacy, safety, and tolerability of ACT-128800 in patients with relapsing-remitting multiple sclerosis.

Interventions

DRUGACT-128800 Dose 1

ACT-128800 (Dose 1) administered orally once daily

DRUGPlacebo

Matching placebo administered orally once daily

DRUGACT-128800 Dose 2

ACT-128800 (Dose 2) administered orally once daily

DRUGACT-128800 Dose 3

ACT-128800 (Dose 3) administered orally once daily

Sponsors

Actelion
Lead SponsorINDUSTRY

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)

Eligibility

Sex/Gender
ALL
Age
18 Years to 55 Years
Healthy volunteers
No

Inclusion criteria

* Adult males and females * Diagnosis of RRMS as defined by the revised (2005) McDonald Diagnostic Criteria for Multiple Sclerosis (MS). * Signed inform consent prior to initiation of any study-mandated procedure.

Exclusion criteria

* A diagnosis of MS categorized as primary progressive or secondary progressive or progressive relapsing. * Patients currently treated for an autoimmune disorder other than MS. * Contraindications for MRI. * Ongoing bacterial, viral, or fungal infection. * History or presence of malignancy. Additional inclusion and

Design outcomes

Primary

MeasureTime frameDescription
Cumulative Number of New T1 Gadolinium-Enhancing (Gd+) Lesions on Magnetic Resonance Imaging (MRI) Scan From Week 12 to Week 24From Week 12 to 24Cumulative Number of new T1 gadolinium-enhancing (Gd+) lesions per year on magnetic resonance imaging (MRI) scan from Week 12 to Week 24 were reported. Negative binomial (NB) regression analysis on Per protocol analysis set and imputation was applied for the missing data. Here, MS signifies multiple sclerosis.

Secondary

MeasureTime frameDescription
Annualized Confirmed Relapse RateUp to 24 weeksRelapse: occurrence of acute episode of one or more new symptoms or worsened symptoms of Multiple Sclerosis (MS), not associated with fever/infection and lasting 24 hours after stable 30 days period. Confirmed relapse: increase from baseline at least 0.5 point Expanded Disability Status Scale (EDSS) score or increase of one point in one, two or three Functional Systems (FS), excluding bowel/bladder and cerebral/mental FS. EDSS and FS scores are based on neurological examination for assessing its impairment in MS. Among eight FS, seven are ordinal clinical rating scales ranging from 0-5 or 6 with higher scale indicating overall functional impairment assessing Visual, Brain Stem, Pyramidal, Cerebellar, Sensory, Bowel/Bladder and Cerebral functions. Rating individual FS scores is used to rate EDSS with information concerning gait and use of assistance. EDSS is ordinal clinical scale ranges 0 (normal neurological examination) to 10(death due to MS)
Number of Participants With First Confirmed Relapse as Assessed by Kaplan-Meier Estimate From Baseline to Week 24Baseline to Week 24Relapse: occurrence of acute episode of one or more new symptoms or worsened symptoms of MS, not associated with fever/infection and lasting 24 hours after stable 30 days period. Confirmed relapse: increase from baseline at least 0.5 point Expanded Disability Status Scale (EDSS) score or increase of one point in one, two or three Functional Systems (FS), excluding bowel/bladder and cerebral/mental FS. EDSS and FS scores are based on neurological examination for assessing its impairment in MS. Among eight FS, seven are ordinal clinical rating scales ranging from 0-5 or 6 with higher scale indicating overall functional impairment assessing Visual, Brain Stem, Pyramidal, Cerebellar, Sensory, Bowel/Bladder and Cerebral functions. Rating individual FS scores is used to rate EDSS with information concerning gait and use of assistance. EDSS is ordinal clinical scale ranges 0 (normal neurological examination) to 10(death due to MS). Kaplan-Meier estimate used for Outcome Measure analysis.

Countries

Australia, Austria, Belgium, Bulgaria, Canada, Czechia, Finland, France, Germany, Hungary, Israel, Italy, Netherlands, Poland, Romania, Russia, Serbia, Spain, Sweden, Switzerland, Ukraine, United Kingdom, United States

Participant flow

Participants by arm

ArmCount
Ponesimod 40 mg
Participants received ponesimod capsules once daily as per up-titration schedule with an initial dose of 10 milligram (mg) ponesimod on Days 1 to 7 followed by first up-titration dose of 20 mg ponesimod on Days 8 to 14 and lastly received 40 mg ponesimod as second up-titration dose on Day 15 to Week 24.
119
Ponesimod 20 mg
Participants received ponesimod capsules once daily as per up-titration schedule with an initial dose of 10 mg ponesimod on Days 1 to 7 followed by 20 mg ponesimod on Day 8 to Week 24.
116
Ponesimod 10 mg
Participants received ponesimod capsules once daily as per up-titration schedule with a dose of 10 mg ponesimod on Day 1 to Week 24.
108
Placebo
Participants received the ponesimod matching placebo tablets once daily for up to Week 24 as per up-titration schedule.
121
Total464

Withdrawals & dropouts

PeriodReasonFG000FG001FG002FG003
Overall StudyAdministrative reason1230
Overall StudyLost to Follow-up1010
Overall StudyWithdrawal by Subject4755

Baseline characteristics

CharacteristicPonesimod 40 mgPonesimod 10 mgPonesimod 20 mgPlaceboTotal
Age, Continuous
Age ( years )
36.5 years
STANDARD_DEVIATION 8.52
36.9 years
STANDARD_DEVIATION 9.24
35.3 years
STANDARD_DEVIATION 8.52
36.6 years
STANDARD_DEVIATION 8.58
36.3 years
STANDARD_DEVIATION 8.7
Ethnicity (NIH/OMB)
Hispanic or Latino
2 Participants0 Participants0 Participants0 Participants2 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
0 Participants0 Participants0 Participants0 Participants0 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
117 Participants108 Participants116 Participants121 Participants462 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants0 Participants0 Participants1 Participants1 Participants
Race (NIH/OMB)
Asian
1 Participants1 Participants0 Participants0 Participants2 Participants
Race (NIH/OMB)
Black or African American
2 Participants2 Participants2 Participants6 Participants12 Participants
Race (NIH/OMB)
More than one race
0 Participants0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
Unknown or Not Reported
2 Participants0 Participants0 Participants0 Participants2 Participants
Race (NIH/OMB)
White
114 Participants105 Participants114 Participants114 Participants447 Participants
Region of Enrollment
Australia
0 Participants0 Participants1 Participants0 Participants1 Participants
Region of Enrollment
Austria
2 Participants2 Participants2 Participants3 Participants9 Participants
Region of Enrollment
Belgium
2 Participants0 Participants0 Participants0 Participants2 Participants
Region of Enrollment
Bulgaria
5 Participants5 Participants4 Participants5 Participants19 Participants
Region of Enrollment
Canada
3 Participants4 Participants3 Participants3 Participants13 Participants
Region of Enrollment
Czech Republic
14 Participants12 Participants14 Participants12 Participants52 Participants
Region of Enrollment
Finland
6 Participants4 Participants4 Participants6 Participants20 Participants
Region of Enrollment
France
1 Participants1 Participants1 Participants1 Participants4 Participants
Region of Enrollment
Germany
1 Participants1 Participants2 Participants2 Participants6 Participants
Region of Enrollment
Hungary
7 Participants2 Participants7 Participants3 Participants19 Participants
Region of Enrollment
Israel
3 Participants1 Participants2 Participants3 Participants9 Participants
Region of Enrollment
Italy
8 Participants6 Participants7 Participants7 Participants28 Participants
Region of Enrollment
Netherlands
1 Participants2 Participants1 Participants2 Participants6 Participants
Region of Enrollment
Poland
7 Participants10 Participants8 Participants12 Participants37 Participants
Region of Enrollment
Romania
1 Participants3 Participants2 Participants3 Participants9 Participants
Region of Enrollment
Russia
9 Participants8 Participants9 Participants7 Participants33 Participants
Region of Enrollment
Serbia
10 Participants11 Participants10 Participants11 Participants42 Participants
Region of Enrollment
Spain
4 Participants3 Participants2 Participants4 Participants13 Participants
Region of Enrollment
Sweden
5 Participants4 Participants6 Participants6 Participants21 Participants
Region of Enrollment
Switzerland
0 Participants2 Participants2 Participants1 Participants5 Participants
Region of Enrollment
Ukraine
5 Participants5 Participants6 Participants7 Participants23 Participants
Region of Enrollment
United Kingdom
5 Participants4 Participants5 Participants4 Participants18 Participants
Region of Enrollment
United States
20 Participants18 Participants18 Participants19 Participants75 Participants
Sex: Female, Male
Gender
Female
79 Participants71 Participants78 Participants85 Participants313 Participants
Sex: Female, Male
Gender
Male
40 Participants37 Participants38 Participants36 Participants151 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
EG002
affected / at risk
EG003
affected / at risk
deaths
Total, all-cause mortality
0 / 1190 / 1140 / 1080 / 121
other
Total, other adverse events
83 / 11973 / 11469 / 10877 / 121
serious
Total, serious adverse events
3 / 1197 / 1147 / 1085 / 121

Outcome results

Primary

Cumulative Number of New T1 Gadolinium-Enhancing (Gd+) Lesions on Magnetic Resonance Imaging (MRI) Scan From Week 12 to Week 24

Cumulative Number of new T1 gadolinium-enhancing (Gd+) lesions per year on magnetic resonance imaging (MRI) scan from Week 12 to Week 24 were reported. Negative binomial (NB) regression analysis on Per protocol analysis set and imputation was applied for the missing data. Here, MS signifies multiple sclerosis.

Time frame: From Week 12 to 24

Population: Per protocol analysis set included participants of mITT set (randomized participants who received at least one dose of study drug, and had at least one valid post-baseline MRI) who met the criteria for evaluable participants for the analysis of MRI data (participants with Relapsing-remitting multiple sclerosis (RRMS) received study drug until 168 days, two post-baseline MRIs b/w Week 12-24, no forbidden treatment for MS).

ArmMeasureValue (MEAN)Dispersion
Ponesimod 40 mgCumulative Number of New T1 Gadolinium-Enhancing (Gd+) Lesions on Magnetic Resonance Imaging (MRI) Scan From Week 12 to Week 241.4 LesionsStandard Deviation 3.24
Ponesimod 20 mgCumulative Number of New T1 Gadolinium-Enhancing (Gd+) Lesions on Magnetic Resonance Imaging (MRI) Scan From Week 12 to Week 241.1 LesionsStandard Deviation 1.96
Ponesimod 10 mgCumulative Number of New T1 Gadolinium-Enhancing (Gd+) Lesions on Magnetic Resonance Imaging (MRI) Scan From Week 12 to Week 243.5 LesionsStandard Deviation 7.27
PlaceboCumulative Number of New T1 Gadolinium-Enhancing (Gd+) Lesions on Magnetic Resonance Imaging (MRI) Scan From Week 12 to Week 246.2 LesionsStandard Deviation 13.42
p-value: <0.000195% CI: [0.133, 0.384]Negative binomial regression model
p-value: <0.000195% CI: [0.1, 0.289]Negative binomial regression model
p-value: 0.031895% CI: [0.337, 0.952]Negative binomial regression model
Secondary

Annualized Confirmed Relapse Rate

Relapse: occurrence of acute episode of one or more new symptoms or worsened symptoms of Multiple Sclerosis (MS), not associated with fever/infection and lasting 24 hours after stable 30 days period. Confirmed relapse: increase from baseline at least 0.5 point Expanded Disability Status Scale (EDSS) score or increase of one point in one, two or three Functional Systems (FS), excluding bowel/bladder and cerebral/mental FS. EDSS and FS scores are based on neurological examination for assessing its impairment in MS. Among eight FS, seven are ordinal clinical rating scales ranging from 0-5 or 6 with higher scale indicating overall functional impairment assessing Visual, Brain Stem, Pyramidal, Cerebellar, Sensory, Bowel/Bladder and Cerebral functions. Rating individual FS scores is used to rate EDSS with information concerning gait and use of assistance. EDSS is ordinal clinical scale ranges 0 (normal neurological examination) to 10(death due to MS)

Time frame: Up to 24 weeks

Population: All treated analysis set included all randomized participants who received at least one dose of study drug.

ArmMeasureValue (MEAN)Dispersion
Ponesimod 40 mgAnnualized Confirmed Relapse Rate0.224 Relapse per yearStandard Deviation 0.7834
Ponesimod 20 mgAnnualized Confirmed Relapse Rate0.396 Relapse per yearStandard Deviation 1.0169
Ponesimod 10 mgAnnualized Confirmed Relapse Rate0.297 Relapse per yearStandard Deviation 0.7987
PlaceboAnnualized Confirmed Relapse Rate0.601 Relapse per yearStandard Deviation 1.6626
Secondary

Number of Participants With First Confirmed Relapse as Assessed by Kaplan-Meier Estimate From Baseline to Week 24

Relapse: occurrence of acute episode of one or more new symptoms or worsened symptoms of MS, not associated with fever/infection and lasting 24 hours after stable 30 days period. Confirmed relapse: increase from baseline at least 0.5 point Expanded Disability Status Scale (EDSS) score or increase of one point in one, two or three Functional Systems (FS), excluding bowel/bladder and cerebral/mental FS. EDSS and FS scores are based on neurological examination for assessing its impairment in MS. Among eight FS, seven are ordinal clinical rating scales ranging from 0-5 or 6 with higher scale indicating overall functional impairment assessing Visual, Brain Stem, Pyramidal, Cerebellar, Sensory, Bowel/Bladder and Cerebral functions. Rating individual FS scores is used to rate EDSS with information concerning gait and use of assistance. EDSS is ordinal clinical scale ranges 0 (normal neurological examination) to 10(death due to MS). Kaplan-Meier estimate used for Outcome Measure analysis.

Time frame: Baseline to Week 24

Population: All treated analysis set included all randomized participants who received at least one dose of study drug. Here 'N' (number of participants analyzed) included all participants who were evaluated for this outcome measure.

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
Ponesimod 40 mgNumber of Participants With First Confirmed Relapse as Assessed by Kaplan-Meier Estimate From Baseline to Week 2410 Participants
Ponesimod 20 mgNumber of Participants With First Confirmed Relapse as Assessed by Kaplan-Meier Estimate From Baseline to Week 2417 Participants
Ponesimod 10 mgNumber of Participants With First Confirmed Relapse as Assessed by Kaplan-Meier Estimate From Baseline to Week 2414 Participants
PlaceboNumber of Participants With First Confirmed Relapse as Assessed by Kaplan-Meier Estimate From Baseline to Week 2425 Participants

Source: ClinicalTrials.gov · Data processed: Mar 8, 2026