Multicenter, Randomized, Double-blind, Placebo-controlled Study to Evaluate Efficacy, Safety, and Tolerability of IMU-838 in Patients with Progressive Multiple Sclerosis

Prior treatment

• Therapy-related exclusion criteria: 5. Any previous or current use of the following MS treatments: a) alemtuzumab or belimumab, including their biosimilars, b) cladribine, c) total lymphoid irradiation, and d) bone marrow or stem cell transplantation. 6. Any use of the following MS treatments before the date of randomization (see table in study protocol) 7. Any use of adrenocorticotrophic hormone (ACTH) or occasional use of systemic corticosteroids (oral or intravenous) 30 days before SV2. 8. Use of any investigational product within 8 weeks or 5× the respective PK half-life before the date of informed consent, whichever is longer, and throughout the study. For some investigational products, prolonged biological effects beyond 8 weeks should be considered. For more information, please refer to Clinical Study Protocol.

Lab values

• MS-related exclusion criteria: 1. Any disease other than MS that may better explain the signs and symptoms, including a history of complete transverse myelitis. 2. Clinical signs or presence of laboratory findings suggestive for neuromyelitis optica spectrum disorders (NMOSD) or myelin oligodendrocyte glycoprotein (MOG)-associated encephalomyelitis (i.e., presence of aquaporin-4 antibodies or anti-MOG antibodies). 3. Any MRI finding, atypical for MS, including but not limited to a longitudinally extensive spinal cord lesion. 4. Any active and uncontrolled coexisting autoimmune disease, other than MS (except for type 1 diabetes mellitus and inflammatory bowel disease).

• Adult patients, age 18 to 65 years (inclusive). 2. No evidence of relapse in the last 24 months before randomization, AND Patients diagnosed with either a) SPMS, in patients showing evidence of Gd+ MRI lesions (active SPMS) in the brain or spinal cord, or without Gd+ MRI lesions (non-active SPMS) in the last 12 months, OR b) PPMS according to 2017 revised McDonald Criteria and the 2013 revised classification of disease courses with a disease duration of the progressive disease of ≤10 years
• EDSS score at screening between 3.0 to 6.5 (both inclusive)
• Evidence of disability worsening not temporarily related to a relapse in the last 24 months before randomization, adjudicated by a central independent reviewer, and documented as: a) An increase of EDSS of at least 1.0 point with Screening EDSS of up to 5.5 (inclusive) and 0.5 point for Screening EDSS 6.0 or 6.5 (as documented in patient files in the last 24 months before randomization), OR b) A 20% worsening (or more) in 25-foot walk time or 9-hole peg test time in either hand (as documented in patient files in the last 24 months before randomization), OR c) A written summary of the clinical evidence of disability worsening in the previous 24 months before randomization through a retrospective assessment of disease worsening from patient files.
• Female patients: a) Must be of non-childbearing potential, i.e., 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 at Day 1 (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 of 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 (i.e., 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 [e.g., 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.
• 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 Note: Simultaneous use of male and female condoms with or without any other contraception methods is not permitted. c) If they have a female partner of childbearing potential, the partner should use a highly effective contraceptive method as outlined in inclusion criterion 4. d) If they have a pregnant partner, they must use condoms while taking the IMP to avoid exposure of the fetus to the IMP.
• Willingness and ability to comply with the protocol.
• Written informed consent given by the patient before the beginning of any study-related procedure. For more information, please refer to Clinical Study Protocol.