Skip to content

Clinical Study to Investigate the Long-term Safety, Tolerability, and Efficacy of Ponesimod in Patients With Relapsing-remitting Multiple Sclerosis

Multicenter, Randomized, Double-blind, Parallel-group Extension to Study AC-058B201 to Investigate the Long-term Safety, Tolerability, and Efficacy of Three Doses of Ponesimod, an Oral S1P1 Receptor Agonist, in Patients With Relapsing-remitting Multiple Sclerosis

Status
Completed
Phases
Phase 2
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT01093326
Enrollment
353
Registered
2010-03-25
Start date
2010-05-12
Completion date
2023-09-06
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 is an extension to the study AC-058B201 and will investigate the long-term safety, tolerability and efficacy of ponesimod in patients with relapsing-remitting multiple sclerosis.

Interventions

Ponesimod 10 mg oral use

Ponesimod 20 mg oral use

Ponesimod 40 mg oral use

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

1. Patients who completed study treatment at their regular Week 24 (End of treatment) visit within the core study AC-058B201. 2. Signed informed consent for participating in the extension study.

Exclusion criteria

1\. Any clinically relevant medical or surgical condition, which, in the opinion of the investigator, would put the patient at risk by participating in the extension study.

Design outcomes

Primary

MeasureTime frameDescription
Annualized Relapse Rate (ARR) of Confirmed RelapsesFrom ponesimod start date up to the end of Analysis Period (AP) 3. The actual time varied for each participant and could be up to 13.3 yearsARR is defined as the number of confirmed relapses per year. A relapse is defined as the occurrence of an acute episode of one or more new symptoms, or worsening of existing symptoms of multiple sclerosis (MS), not associated with fever or infection, and lasting for at least 24 hours after a stable period of at least 30 days. A confirmed relapse is a relapse accompanied by an increase from the previous clinically stable assessment (that is, performed at least 30 days after the onset of any previous relapse) of at least 0.5 point in the Expanded Disability Status Scale (EDSS) score, or one point in the score for at least one of the Functional System (FS) scores, excluding the bowel and bladder, and mental FS. EDSS is ordinal clinical scale ranges 0 (normal neurological examination) to 10 (death due to MS).
Time to First Confirmed RelapseFrom ponesimod start date up to the end of Analysis Period (AP) 3. The actual time varied for each participant and could be up to 13.3 yearsTime to first confirmed relapse was reported. A relapse is defined as the occurrence of an acute episode of one or more new symptoms, or worsening of existing symptoms of multiple sclerosis (MS), not associated with fever or infection, and lasting for at least 24 hours after a stable period of at least 30 days. A confirmed relapse is a relapse accompanied by an increase from the previous clinically stable assessment (that is, performed at least 30 days after the onset of any previous relapse) of at least 0.5 point in the Expanded Disability Status Scale (EDSS) score, or one point in the score for at least one of the Functional System (FS) scores, excluding the bowel and bladder, and mental FS. EDSS is ordinal clinical scale ranges from 0 (normal neurological examination) to 10 (death due to MS).
Time to 24 Weeks Confirmed Disability ProgressionFrom ponesimod baseline up to the end of Analysis Period (AP) 3. The actual time varied for each participant and could be up to 13.3 yearsTime to 24 weeks confirmed disability progression (accumulation) was reported. Disability progression is defined as an increase of at least 1 point in the EDSS score if baseline EDSS was between 1 and 5.0, an increase of at least 1.5 points if baseline EDSS was 0, or an increase of at least 0.5 points if the baseline EDSS was equal or greater than 5.5. A 24-week confirmed disability progression is defined as a 24-week sustained increase from baseline in the EDSS scores, that is, every EDSS score (scheduled or unscheduled, with or without relapse) within a 24-week duration after the first progression should meet the progression criteria as specified above. EDSS is ordinal clinical scale ranges from 0 (normal neurological examination) to 10 (death due to MS).

Other

MeasureTime frameDescription
Number of Participants With at Least One Treatment-emergent Serious Adverse Events (SAEs)From ponesimod start date up to the end of study treatment + 15 Days. The actual time of observation varied for each participant and could be up to 12.97 years + 15 daysNumber of participants with at least one treatment-emergent SAEs were reported. An adverse event (AE) is any untoward medical occurrence in a participant participating in a clinical study that does not necessarily have a causal relationship with the pharmaceutical/biological agent under study. An SAE is an AE resulting in any of the following outcomes or deemed significant for any other reason: death; initial or prolonged inpatient hospitalisation; life-threatening experience (immediate risk of dying); persistent or significant disability/incapacity; congenital anomaly/birth defect; suspected transmission of any infectious agent via a medicinal product or medically important. Treatment-emergent SAEs were those SAEs that occurred at or after the initial administration of ponesimod up to 15 days (inclusive) after last administration of ponesimod as study drug.

Countries

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

Participant flow

Recruitment details

Participants who were enrolled in the core study (NCT01006265) entered this extension study. As planned, combined analysis (core plus extension study) was done for efficacy and safety (435 participants).

Pre-assignment details

Data reported in each arm are based on first dose received during treatment period (TP) 1.

Participants by arm

ArmCount
Ponesimod 10 Milligrams (mg)
Participants with relapsing-remitting multiple sclerosis having completed their regular Week 24 treatment visit of the core study (NCT01006265) while receiving ponesimod 10 mg or placebo, entered this extension study and received ponesimod 10 mg capsules orally once daily during treatment period (TP) 1. Participants continued to receive ponesimod 10 mg tablet orally, once daily during TP2. All participants received ponesimod 20 mg tablet orally, once daily during TP3.
115
Ponesimod 20 Milligrams (mg)
Participants with relapsing-remitting multiple sclerosis having completed their regular Week 24 treatment visit of the core study (NCT01006265) while receiving ponesimod 20 mg or placebo, entered this extension study and received ponesimod 20 mg capsules orally once daily during TP1. Participants continued to receive ponesimod 20 mg tablet orally, once daily during TP2 and TP3.
121
Ponesimod 40 Milligrams (mg)
Participants with relapsing-remitting multiple sclerosis having completed their regular Week 24 treatment visit of the core study (NCT01006265) while receiving ponesimod 40 mg or placebo, entered this extension study and received ponesimod 40 mg capsules orally once daily during TP1. Participants were then re-randomized to receive ponesimod 10 or 20 mg tablet orally, once daily during TP2. All participants received ponesimod 20 mg tablet orally, once daily during TP3.
117
Total353

Withdrawals & dropouts

PeriodReasonFG000FG001FG002
Overall StudyAdverse Event214
Overall StudyDeath010
Overall StudyLack of Efficacy763
Overall StudyLost to Follow-up254
Overall StudyOther001
Overall StudyPhysician Decision313
Overall StudyWithdrawal by Subject302726

Baseline characteristics

CharacteristicTotalPonesimod 10 Milligrams (mg)Ponesimod 20 Milligrams (mg)Ponesimod 40 Milligrams (mg)
Age, Categorical
<=18 years
0 Participants0 Participants0 Participants0 Participants
Age, Categorical
>=65 years
0 Participants0 Participants0 Participants0 Participants
Age, Categorical
Between 18 and 65 years
353 Participants115 Participants121 Participants117 Participants
Age, Continuous36.2 years
STANDARD_DEVIATION 8.6
36.6 years
STANDARD_DEVIATION 8.67
36.1 years
STANDARD_DEVIATION 8.58
35.9 years
STANDARD_DEVIATION 8.61
Ethnicity (NIH/OMB)
Hispanic or Latino
2 Participants0 Participants0 Participants2 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
0 Participants0 Participants0 Participants0 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
351 Participants115 Participants121 Participants115 Participants
Race (NIH/OMB)
American Indian or Alaska Native
1 Participants0 Participants1 Participants0 Participants
Race (NIH/OMB)
Asian
1 Participants0 Participants0 Participants1 Participants
Race (NIH/OMB)
Black or African American
9 Participants3 Participants2 Participants4 Participants
Race (NIH/OMB)
More than one race
0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
Unknown or Not Reported
2 Participants0 Participants0 Participants2 Participants
Race (NIH/OMB)
White
340 Participants112 Participants118 Participants110 Participants
Region of Enrollment
Austria
8 Participants4 Participants2 Participants2 Participants
Region of Enrollment
Bulgaria
13 Participants5 Participants3 Participants5 Participants
Region of Enrollment
Canada
6 Participants2 Participants2 Participants2 Participants
Region of Enrollment
Czech Republic
43 Participants12 Participants17 Participants14 Participants
Region of Enrollment
Finland
16 Participants6 Participants6 Participants4 Participants
Region of Enrollment
France
3 Participants1 Participants1 Participants1 Participants
Region of Enrollment
Germany
4 Participants1 Participants1 Participants2 Participants
Region of Enrollment
Hungary
15 Participants2 Participants8 Participants5 Participants
Region of Enrollment
Israel
3 Participants0 Participants2 Participants1 Participants
Region of Enrollment
Italy
22 Participants8 Participants8 Participants6 Participants
Region of Enrollment
Netherlands
2 Participants0 Participants1 Participants1 Participants
Region of Enrollment
Poland
31 Participants14 Participants6 Participants11 Participants
Region of Enrollment
Romania
3 Participants1 Participants2 Participants0 Participants
Region of Enrollment
Russia
30 Participants8 Participants11 Participants11 Participants
Region of Enrollment
Serbia
40 Participants16 Participants13 Participants11 Participants
Region of Enrollment
Spain
9 Participants1 Participants4 Participants4 Participants
Region of Enrollment
Sweden
18 Participants4 Participants6 Participants8 Participants
Region of Enrollment
Switzerland
3 Participants2 Participants1 Participants0 Participants
Region of Enrollment
Ukraine
16 Participants4 Participants7 Participants5 Participants
Region of Enrollment
United Kingdom
14 Participants5 Participants4 Participants5 Participants
Region of Enrollment
United States
54 Participants19 Participants16 Participants19 Participants
Sex: Female, Male
Female
233 Participants77 Participants80 Participants76 Participants
Sex: Female, Male
Male
120 Participants38 Participants41 Participants41 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
EG002
affected / at risk
deaths
Total, all-cause mortality
0 / 1391 / 1450 / 151
other
Total, other adverse events
121 / 139125 / 145140 / 151
serious
Total, serious adverse events
32 / 13935 / 14525 / 151

Outcome results

Primary

Annualized Relapse Rate (ARR) of Confirmed Relapses

ARR is defined as the number of confirmed relapses per year. A relapse is defined as the occurrence of an acute episode of one or more new symptoms, or worsening of existing symptoms of multiple sclerosis (MS), not associated with fever or infection, and lasting for at least 24 hours after a stable period of at least 30 days. A confirmed relapse is a relapse accompanied by an increase from the previous clinically stable assessment (that is, performed at least 30 days after the onset of any previous relapse) of at least 0.5 point in the Expanded Disability Status Scale (EDSS) score, or one point in the score for at least one of the Functional System (FS) scores, excluding the bowel and bladder, and mental FS. EDSS is ordinal clinical scale ranges 0 (normal neurological examination) to 10 (death due to MS).

Time frame: From ponesimod start date up to the end of Analysis Period (AP) 3. The actual time varied for each participant and could be up to 13.3 years

Population: Ponesimod analysis set (PAS) included all participants who received at least one dose of ponesimod at any time during the core and/or the extension study (435 participants).

ArmMeasureValue (MEAN)
Ponesimod 10 Milligrams (mg)Annualized Relapse Rate (ARR) of Confirmed Relapses0.205 Confirmed relapses per year
Ponesimod 20 Milligrams (mg)Annualized Relapse Rate (ARR) of Confirmed Relapses0.142 Confirmed relapses per year
Ponesimod 40 Milligrams (mg)Annualized Relapse Rate (ARR) of Confirmed Relapses0.150 Confirmed relapses per year
Primary

Time to 24 Weeks Confirmed Disability Progression

Time to 24 weeks confirmed disability progression (accumulation) was reported. Disability progression is defined as an increase of at least 1 point in the EDSS score if baseline EDSS was between 1 and 5.0, an increase of at least 1.5 points if baseline EDSS was 0, or an increase of at least 0.5 points if the baseline EDSS was equal or greater than 5.5. A 24-week confirmed disability progression is defined as a 24-week sustained increase from baseline in the EDSS scores, that is, every EDSS score (scheduled or unscheduled, with or without relapse) within a 24-week duration after the first progression should meet the progression criteria as specified above. EDSS is ordinal clinical scale ranges from 0 (normal neurological examination) to 10 (death due to MS).

Time frame: From ponesimod baseline up to the end of Analysis Period (AP) 3. The actual time varied for each participant and could be up to 13.3 years

Population: PAS included all participants who received at least one dose of ponesimod at any time during the core and/or the extension study (435 participants).

ArmMeasureValue (MEDIAN)
Ponesimod 10 Milligrams (mg)Time to 24 Weeks Confirmed Disability ProgressionNA Weeks
Ponesimod 20 Milligrams (mg)Time to 24 Weeks Confirmed Disability ProgressionNA Weeks
Ponesimod 40 Milligrams (mg)Time to 24 Weeks Confirmed Disability ProgressionNA Weeks
Primary

Time to First Confirmed Relapse

Time to first confirmed relapse was reported. A relapse is defined as the occurrence of an acute episode of one or more new symptoms, or worsening of existing symptoms of multiple sclerosis (MS), not associated with fever or infection, and lasting for at least 24 hours after a stable period of at least 30 days. A confirmed relapse is a relapse accompanied by an increase from the previous clinically stable assessment (that is, performed at least 30 days after the onset of any previous relapse) of at least 0.5 point in the Expanded Disability Status Scale (EDSS) score, or one point in the score for at least one of the Functional System (FS) scores, excluding the bowel and bladder, and mental FS. EDSS is ordinal clinical scale ranges from 0 (normal neurological examination) to 10 (death due to MS).

Time frame: From ponesimod start date up to the end of Analysis Period (AP) 3. The actual time varied for each participant and could be up to 13.3 years

Population: PAS included all participants who received at least one dose of ponesimod at any time during the core and/or the extension study (435 participants).

ArmMeasureValue (MEDIAN)
Ponesimod 10 Milligrams (mg)Time to First Confirmed Relapse272.3 Weeks
Ponesimod 20 Milligrams (mg)Time to First Confirmed Relapse656.7 Weeks
Ponesimod 40 Milligrams (mg)Time to First Confirmed Relapse431.7 Weeks
Other Pre-specified

Number of Participants With at Least One Treatment-emergent Serious Adverse Events (SAEs)

Number of participants with at least one treatment-emergent SAEs were reported. An adverse event (AE) is any untoward medical occurrence in a participant participating in a clinical study that does not necessarily have a causal relationship with the pharmaceutical/biological agent under study. An SAE is an AE resulting in any of the following outcomes or deemed significant for any other reason: death; initial or prolonged inpatient hospitalisation; life-threatening experience (immediate risk of dying); persistent or significant disability/incapacity; congenital anomaly/birth defect; suspected transmission of any infectious agent via a medicinal product or medically important. Treatment-emergent SAEs were those SAEs that occurred at or after the initial administration of ponesimod up to 15 days (inclusive) after last administration of ponesimod as study drug.

Time frame: From ponesimod start date up to the end of study treatment + 15 Days. The actual time of observation varied for each participant and could be up to 12.97 years + 15 days

Population: Ponesimod analysis set included all participants who received at least one dose of ponesimod at any time during the core and/or the extension study (435 participants).

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
Ponesimod 10 Milligrams (mg)Number of Participants With at Least One Treatment-emergent Serious Adverse Events (SAEs)32 Participants
Ponesimod 20 Milligrams (mg)Number of Participants With at Least One Treatment-emergent Serious Adverse Events (SAEs)35 Participants
Ponesimod 40 Milligrams (mg)Number of Participants With at Least One Treatment-emergent Serious Adverse Events (SAEs)25 Participants

Source: ClinicalTrials.gov · Data processed: Mar 21, 2026