CONFIRM
What it found
The main measure showed a statistically significant benefit.
“At 2 years, the annualized relapse rate was significantly lower with twice-daily BG-12 (0.22), thrice-daily BG-12 (0.20), and glatiramer acetate (0.29) than with placebo (0.40) (relative reductions: twice-daily BG-12, 44%, P<0.001; thrice-daily BG-12, 51%, P<0.001; glatiramer acetate, 29%, P=0.01).”Read by software from the paper's abstract
annualized relapse rate over a period of 2 years · 2 years
| Group | n | Value |
|---|---|---|
| twice-daily BG-12 | 0.22 | |
| thrice-daily BG-12 | 0.20 | |
| glatiramer acetate | 0.29 | |
| placebo | 0.40 |
relative reduction vs placebo 44% (twice-daily BG-12); 51% (thrice-daily BG-12); 29% (glatiramer acetate)
p = <0.001 (twice-daily BG-12); P<0.001 (thrice-daily BG-12); P=0.01 (glatiramer acetate)
Read by software from the paper's abstract
What was tested
Treatment tested
- Dimethyl fumarate
Kelch-like ECH-associated protein 1 inhibitor
Compared with
- Glatiramer acetate
Unknown
Placebo or sham
- Placebo
Results by group
Annualized Relapse Rate
2 years
| Group | Value | Interval | Number analysed |
|---|---|---|---|
| Placebo | 0.401 Relapses Per Year | 0.329–0.488 | 363 |
| BG00012 240 mg Twice Daily (BID) | 0.224 Relapses Per Year | 0.179–0.282 | 359 |
| BG00012 240 mg 3 Times Daily (TID) | 0.198 Relapses Per Year | 0.156–0.252 | 345 |
| Glatiramer Acetate (GA) 20 mg Injection Once Daily (QD) | 0.286 Relapses Per Year | 0.232–0.353 | 350 |
Placebo
BG00012 240 mg Twice Daily (BID)
BG00012 240 mg 3 Times Daily (TID)
Glatiramer Acetate (GA) 20 mg Injection Once Daily (QD)
Values as posted on ClinicalTrials.gov. Outcomes measured differently across trials are not directly comparable.
Safety
| Group | Participants at risk | Serious adverse events | Deaths |
|---|---|---|---|
| Placebo | 363 | 79 (21.8%) | |
| BG00012 240 mg Twice Daily (BID) | 359 | 61 (17.0%) | |
| BG00012 240 mg 3 Times Daily (TID) | 344 | 54 (15.7%) | |
| Total BG00012 | 703 | 115 (16.4%) | |
| Glatiramer Acetate (GA) 20 mg Injection Once Daily (QD) | 351 | 60 (17.1%) |
As posted on ClinicalTrials.gov. Serious adverse events include any serious health event during the trial, whether or not the treatment caused it.
What it measured
Main measures
Annualized Relapse Rate
2 years
Disability progressionRelapsesRate of clinical relapses at 2 years
Relapses
Other measures (4)
Number of New or Newly Enlarging T2 Hyperintense Lesions
2 years
MRI lesionsNumber of New T1 Hypointense Lesions
2 years
MRI lesionsProportion of Subjects Relapsed
2 years
RelapsesProportion of Subjects Experiencing Progression of Disability Assessed Using the Expanded Disability Status Scale (EDSS)
2 years
Disability progression
Who could take part
Relapsing MS · 18 to 55
Unless otherwise specified, to be eligible to participate in this study, candidates must meet the following eligibility criteria at the time of the randomization: Key Inclusion Criteria: * Must have confirmed diagnosis of RRMS according to McDonald criteria #1-4 * Must have a baseline EDSS between 0.0 and 5.0, inclusive. * Must have relapsing-remitting disease course. Key Exclusion Criteria: * Other chronic disease of immune system, malignancies, urologic, pulmonary, gastrointestinal disease * Pregnant or nursing women Note: Other protocol-defined inclusion/exclusion criteria may apply.
As registered. Criteria can change, so ask the trial team or your neurologist.
About this trial
In the sponsor's words
To determine if treatment with BG00012 can decrease the number of MS relapses during a certain time period. Other goals of the study are to determine if, over time, BG00012 treatment can decrease the number of certain types of brain lesions commonly seen in MS patients and slow down the time it takes for MS to get worse. Other objectives of the study are to determine the safety and tolerability of BG00012, as well as the effect it may have on tests and evaluations used to assess MS. Additionally, glatiramer acetate is being used to compare its benefits and risks with placebo and BG00012.
Papers
Results
Long-term safety and efficacy of dimethyl fumarate for up to 13 years in patients with relapsing-remitting multiple sclerosis: Final ENDORSE study results.Mult Scler · 2022
Results
Dimethyl fumarate treatment shifts the immune environment toward an anti-inflammatory cell profile while maintaining protective humoral immunity.Mult Scler · 2021
Results
Efficacy and Safety of Delayed-release Dimethyl Fumarate for Relapsing-remitting Multiple Sclerosis in Prior Interferon Users: An Integrated Analysis of DEFINE and CONFIRM.Clin Ther · 2017
Results
Effect of delayed-release dimethyl fumarate on no evidence of disease activity in relapsing-remitting multiple sclerosis: integrated analysis of the phase III DEFINE and CONFIRM studies.Eur J Neurol · 2017
Results
Comparing outcomes from clinical studies of oral disease-modifying therapies (dimethyl fumarate, fingolimod, and teriflunomide) in relapsing MS: Assessing absolute differences using a number needed to treat analysis.Mult Scler Relat Disord · 2016
Results
Time course of clinical and neuroradiological effects of delayed-release dimethyl fumarate in multiple sclerosis.Eur J Neurol · 2015
Results
Effects of delayed-release dimethyl fumarate on MRI measures in the phase 3 CONFIRM study.Neurology · 2015
Results
Effects of delayed-release dimethyl fumarate (DMF) on health-related quality of life in patients with relapsing-remitting multiple sclerosis: an integrated analysis of the phase 3 DEFINE and CONFIRM studies.Clin Ther · 2014
Results
Placebo-controlled phase 3 study of oral BG-12 or glatiramer in multiple sclerosis.N Engl J Med · 2012
At 2 years, the annualized relapse rate was significantly lower with twice-daily BG-12 (0.22), thrice-daily BG-12 (0.20), and glatiramer acetate (0.29) than with placebo (0.40) (relative reductions: twice-daily BG-12, 44%, P<0.001; thrice-daily BG-12, 51%, P<0.001; glatiramer acetate, 29%, P=0.01).
Read by software from the paper's abstract
Results
Amezcua L, Mao-Draayer Y, Vargas WS, Farber R, Schaefer S, Branco F, England SM, Belviso N, Lewin JB, Mendoza JP, Shankar SL; ENDORSE Study Investigators. Efficacy of Dimethyl Fumarate in Young Adults with Relapsing-Remitting Multiple Sclerosis: Analysis of the DEFINE, CONFIRM, and ENDORSE Studies. Neurol Ther. 2023 Jun;12(3):883-897. doi: 10.1007/s40120-023-00475-8. Epub 2023 Apr 15.
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History
Started
Jun 2007
Main results due
Aug 2011
Finished
Aug 2011
Results posted
Jun 2014
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