Study to Evaluate the Efficacy, Safety, and Tolerability of IMU-838 in Patients With Relapsing Multiple Sclerosis

Phase 3

Recruiting

• Conditions: Multiple Sclerosis
• Interventions: Drug: IMU-838 tablets; Drug: Placebo matching IMU-838 tablets

• Registration Number: NCT05134441
• Lead Sponsor: Immunic AG

Brief Summary

Multi-Center, Randomized, Double-Blinded Phase 3 Study to Evaluate the Efficacy, Safety, and Tolerability of IMU-838 versus Placebo in Adults with Relapsing Multiple Sclerosis (ENSURE-1)

Detailed Description

This study will be a multicenter, randomized, double-blind, placebo-controlled study with a blinded Main Treatment Period (MT) and an Open Label Period (OLE) to evaluate the efficacy, safety, and tolerability of IMU-838 in adult patients with RMS. The study will consist of the following periods:

Screening Period: Approximately 28 days Main Treatment Period: Up to 72 weeks (approximately 15 months) Open Label Extension Period: Up to approximately 8 years

Study Timeline

• Study First Submitted: 2021-09-30
• Study Start: 2021-11-18
• Study First Submitted QC: 2021-11-19
• Study First Posted: 2021-11-26
• Status Verified: 2024-04
• Last Update Submitted: 2024-04-17
• Last Update Posted: 2024-04-18
• Primary Completion: 2024-09
• Study Completion: 2032-09

Recruitment & Eligibility

• Status: RECRUITING
• Sex: All
• Target Recruitment: 1050

Inclusion Criteria

• Male or female patient (age ≥18 to ≤55 years).

• Patients with an established diagnosis of MS according to 2017 McDonald Criteria.

• Patients with RMS comprising of relapsing remitting MS (RRMS) and active secondary progressive MS, both defined according to Lublin criteria 1996 and 2014.

• Active disease as defined by Lublin 2014 evidenced prior to Screening by:

  1. At least 2 relapses in the last 24 months before randomization, or
  2. At least 1 relapse in the last 12 months before randomization, or
  3. A positive Gd+ MRI scan (brain and/or spine) in the last 12 months prior to randomization.

• Willingness and ability to comply with the protocol.

• Written informed consent given prior to any study-related procedure.

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Exclusion Criteria

• Patients with non-active secondary progressive MS and primary progressive MS.
• Any disease other than MS that may better explain the signs and symptoms, including history of complete transverse myelitis.
• Clinical signs or presence of laboratory findings suggestive for neuromyelitis optica (NMO) spectrum disorders or myelin oligodendrocyte glycoprotein (MOG)-IgG-associated encephalomyelitis
• Any active and uncontrolled coexisting autoimmune disease, other than MS (except for type 1 diabetes mellitus and inflammatory bowel disease)
• Use of experimental/investigational drug (with the exception ofCOVID-19 vaccines approved by emergency use authorization) and/or participation in drug clinical studies within 6 months prior to Screening
• Previous or current use of MS treatments lifelong, or within a pre-specified time period.
• Use of the pre-specified concomitant medications.
• Clinically significantly abnormal and pre-specified lab values.
• History of chronic systemic infections within 6 months before the date of informed consent.
• Diagnosis or suspected liver function impairment, which may cause fluctuating liver function tests during this study.
• Known history of nephrolithiasis or underlying condition with a strong association of nephrolithiasis.
• History or clinical diagnosis of gout.
• History or presence of any major medical or psychiatric illness
• Substantial medical condition that could create undue risk to the patient, could affect adherence with the study protocol or could undesirably affect study outcomes

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Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
IMU-838	IMU-838 tablets	IMU-838 (vidofludimus calcium), a small molecule inhibitor of DHODH. Formulation: Tablets with 15 or 30 mg IMU-838 for once daily oral intake in the morning.
Placebo	Placebo matching IMU-838 tablets	Matching placebo, as described for the test product, identical number of tablets as given for IMU-838.

Primary Outcome Measures

Name	Time	Method
To evaluate efficacy of IMU-838 versus placebo regarding time to first relapse	72 weeks	Survival analysis of time to first relapse, occurred after the start of study treatment administration and before the end of the double-blind period, censored at a maximum of 72 weeks.

Secondary Outcome Measures

Name	Time	Method
Effect of IMU-838 versus placebo on volume of new T2 lesions	72 weeks	To evaluate the effect of IMU-838 versus placebo on volume of new T2 lesions. Mean difference between IMU-838- and placebo in changes of the volume of new MRI T2 lesions over 24-weeks of treatment in the double-blind period.
Effect of IMU-838 versus placebo on disability progression	72 weeks	To evaluate the effect of IMU-838 versus placebo on disability progression. Survival analysis of time to 12-week confirmed disability progression, as measured on Expanded Disability Status Scale during the double-blind period, censored at maximum 72-weeks.
Effect of IMU-838 versus placebo on cognitive performance	72 weeks	To evaluate the effect of IMU-838 versus placebo on cognitive performance. Survival analysis of time to confirmed clinically relevant changes on Symbol Digit Modalities Test during the double-blind period, censored at maximum 72-weeks.
Effect of IMU-838 versus placebo on whole brain atrophy	72 weeks	To evaluate the effect of IMU-838 versus placebo on whole brain atrophy. Difference in the mean of the percentage change on the whole brain volume between IMU-838 and placebo during the 72-weeks double-blind period.
Safety of IMU-838 versus placebo	72 weeks	To evaluate safety and tolerability of IMU-838 versus placebo by assessing rates of Treatment Emergent Adverse Events, Adverse Events of Special Interest, Serious Adverse Events, changes in levels of pre-specified laboratory parameters, vital signs and ECG parameters and rates and reasons for study discontinuations.

Trial Locations

Locations (86)

Xenoscience, Inc., 21st Century Neurology; 🇺🇸 Phoenix, Arizona, United States

Bradenton Research Center; 🇺🇸 Bradenton, Florida, United States

Hygeia Hospital Tirana; 🇦🇱 Tirana, Albania

MC Exacta Medica OOD; 🇧🇬 Pleven, Bulgaria

UMHAT Sveti Georgi; 🇧🇬 Plovdiv, Bulgaria

Diagnostic and Consultative Center Neoclinic; 🇧🇬 Sofia, Bulgaria

Collier Neurologic Specialists; 🇺🇸 Naples, Florida, United States

Neurology Associates of Ormond Beach; 🇺🇸 Ormond Beach, Florida, United States

Klinika Mjekesore Nuova, Neurology Clinic; 🇦🇱 Tirana, Albania

Consultants in Neurology, Ltd; 🇺🇸 Northbrook, Illinois, United States

MHAT Puls AD; 🇧🇬 Blagoevgrad, Bulgaria

UMHAT "Medica Ruse"; 🇧🇬 Ruse, Bulgaria

MHATNP "Sveti Naum", EAD; 🇧🇬 Sofia, Bulgaria

MHAT "Heart and Brain", EAD; 🇧🇬 Burgas, Bulgaria

Hospital Universitario La Paz; 🇪🇸 Madrid, Spain

Reliant Medical Research, LLC; 🇺🇸 Miami, Florida, United States

UMHAT "Sveti Ivan Rilski" EAD; 🇧🇬 Sofia, Bulgaria

MHAT "Sveta Sofia" EOOD; 🇧🇬 Sofia, Bulgaria

LTD New Hospitals; 🇬🇪 Tbilisi, Georgia

Indira Gandhi Medical College & Hospital; 🇮🇳 Shimla, India

AUB Medical Center; 🇱🇧 Hamra, Lebanon

Neurociencias Estudios Clínicos S.C; 🇲🇽 Culiacán, Mexico

Cliditer S.A de C.V; 🇲🇽 Mexico City, Mexico

General Hospital Niksic; 🇲🇪 Nikšić, Montenegro

Medical and diagnostic center of a LLC "Medcontinent", neurology and rehabilitation center; 🇺🇦 Poltava, Ukraine

J.S.C. Curatio Clinic; 🇬🇪 Tbilisi, Georgia

Katsiashvili Emergency Center; 🇬🇪 Tbilisi, Georgia

MediClub Georgia LLC; 🇬🇪 Tbilisi, Georgia

Ruby Hospital; 🇮🇳 Pune, India

Athens Medical Center; 🇬🇷 Athens, Greece

Thessaloniki Hosptl; 🇬🇷 Thessaloníki, Greece

Hotel Dieu de France Hospital; 🇱🇧 Beirut, Lebanon

TSH Advanced Clinical Center; 🇯🇴 Amman, Jordan

Centro de Morelia; 🇲🇽 Morelia, Mexico

Faicic de RL de CV; 🇲🇽 Veracruz, Mexico

MHAT Avis Medica; 🇧🇬 Pleven, Bulgaria

UMHAT "Alexandrovska"; 🇧🇬 Sofia, Bulgaria

Military Medical Academy; 🇧🇬 Sofia, Bulgaria

MC Vita 1; 🇧🇬 Pleven, Bulgaria

CCB Medical Institute Ministry of Interior; 🇧🇬 Sofia, Bulgaria

UMHATEM N.Pirogov; 🇧🇬 Sofia, Bulgaria

Institute of Medical Sciences Banaras Hindu University,IMS BHU Varanasi; 🇮🇳 Varanasi, India

UMHAT "Sveta Marina" EAD, First Clinic of Neurological Diseases; 🇧🇬 Varna, Bulgaria

UMHAT Dr.Georgi Stranski EAD; 🇧🇬 Pleven, Bulgaria

UMHAT "Alexandrovska" EAD; 🇧🇬 Sofia, Bulgaria

Pineo Medical Ecosystem LTD; 🇬🇪 Tbilisi, Georgia

UMHAT"Tsaritsa Yoanna -ISUL; 🇧🇬 Sofia, Bulgaria

1st Uni Clinic of Tbilisi LEPL; 🇬🇪 Tbilisi, Georgia

Eristavi Experimental Center; 🇬🇪 Tbilisi, Georgia

Heart and Brain University Hospital; 🇧🇬 Pleven, Bulgaria

MHATNPsy Sveti Naum EAD; 🇧🇬 Sofia, Bulgaria

Military Medical Academy MHAT; 🇧🇬 Sofia, Bulgaria

Khechinashvili University Hospital; 🇬🇪 Tbilisi, Georgia

LTD Aversi Clinic; 🇬🇪 Tbilisi, Georgia

Sarajishvili Neurology Institute; 🇬🇪 Tbilisi, Georgia

Kanoria Hospital & Research Centre; 🇮🇳 Gandhinagar, India

Klaipedos Universitetine Ligonine - Klaipedos Issetines Sklerozes Centra; 🇱🇹 Klaipėda, Lithuania

Clínica Colsanitas S.A. Sede Clínica Universitaria Colombia; 🇨🇴 Bogotá, Colombia

Neurocountry Portoazul S.A.S.; 🇨🇴 Puerto Colombia, Colombia

Mallikatte, Kadri; 🇮🇳 Mangalore, India

Jasleen Hospital; 🇮🇳 Nagpur, India

Sir Ganga Ram Hospital; 🇮🇳 New Delhi, India

Irbid Speciality Hospital; 🇯🇴 Irbid, Jordan

Instituto Jalisciense de Metabolismo, SC; 🇲🇽 Guadalajara, Mexico

Medico-Sanitary Public Institution, Institute of Neurology and Neurosurgery "Diomid Gherman"; 🇲🇩 Chisinau, Moldova, Republic of

Neuro Global, LLC; 🇺🇦 Ivano-Frankivs'k, Ukraine

Lietuvos Sveikatos Mokslu Universitetas - Kauno Klinikos; 🇱🇹 Kaunas, Lithuania

Unidad de Investigación en Salud de Chihuahua S.C.; 🇲🇽 Mexico City, Mexico

Clinstile SA de CV; 🇲🇽 Mexico City, Mexico

The Diomid Gherman Institute of Neurology and Neurosurgery; 🇲🇩 Chisinau, Moldova, Republic of

Hospital "8 mi Septemvri"; 🇲🇰 Skopje, North Macedonia

University Clinic of Neurology; 🇲🇰 Skopje, North Macedonia

Clinical Hospital #15 of the Podilskyi District of the Kyiv City; 🇺🇦 Kiev, Ukraine

Sociedad de Metabolismo y Corazon, S.C.; 🇲🇽 Veracruz, Mexico

Grupo medico camino SC; 🇲🇽 Mexico City, Mexico

Clinical Center of Montenegro; 🇲🇪 Podgorica, Montenegro

Chernihiv Regional Hospital; 🇺🇦 Chernivtsi, Ukraine

"Medbud"; 🇺🇦 Kyiv, Ukraine

SMART medical center; 🇺🇦 Kyiv, Ukraine

Instititute of Emergency Medicine; 🇲🇩 Chisinau, Moldova, Republic of

Khmelnytsky regional hospital of war veterans; 🇺🇦 Khmelnytskyi, Ukraine

Kyiv City Hospital 4; 🇺🇦 Kiew, Ukraine

Regional Clinical Center for Neurosurgery and Neurology; 🇺🇦 Uzhhorod, Ukraine

Regional Clinical Hospital; 🇺🇦 Ivano-Frankivs'k, Ukraine

Odesa Regional Clinical Hospital, Department of Neurosurgery; 🇺🇦 Odesa, Ukraine

Ternopil Psycho-Neuro Hospital; 🇺🇦 Ternopil', Ukraine