A Double-masked, Placebo-controlled Study with Open label Period to Evaluate MEDI-551 in NMO/NMOSD
What it found
The main measure showed a statistically significant benefit.
| Measure | Estimate | 95% CI | p |
|---|---|---|---|
| Time to Adjudication Committee (AC)-Determined Neuromyelitis Optica Spectrum Disorder (NMOSD) Attack During RCP | Hazard Ratio (HR) 0.272 | 0.1496–0.4961 | <0.0001 |
Statistical analysis as posted on ClinicalTrials.gov.
What was tested
Treatment tested
- Inebilizumab
B-lymphocyte antigen CD19 binding agent
Placebo or sham
- Placebo
Results by group
Time to Adjudication Committee (AC)-Determined Neuromyelitis Optica Spectrum Disorder (NMOSD) Attack During RCP
Day 1 (Baseline) through Day 197
| Group | Value | Interval | Number analysed |
|---|---|---|---|
| Placebo/Inebilizumab | Not reached | 56 | |
| Inebilizumab/Inebilizumab | Not reached | 174 |
p = <0.0001; Hazard Ratio (HR) 0.272 (95% CI 0.1496–0.4961)
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/Inebilizumab | 56 | 24 (42.9%) | 1 |
| Inebilizumab/Inebilizumab | 174 | 28 (16.1%) | 2 |
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
Time to Adjudication Committee (AC)-Determined Neuromyelitis Optica Spectrum Disorder (NMOSD) Attack During RCP
Day 1 (Baseline) through Day 197
RelapsesTime to an NMO/NMOSD attack determined by Adjudication Committee in randomized-control period
Relapses
Other measures (17)
Percentage of Participants With Worsening in Expanded Disability Severity Scale (EDSS) Score From Baseline to the Last Visit of RCP
Day 1 (Baseline) through Day 197
Disability progressionBladder, bowel and sexual functionChange From Baseline in Low-Contrast Visual Acuity Binocular Score to the Last Visit of RCP
Day 1 (Baseline) through Day 197
VisionCumulative Number of Active Magnetic Resonance Imaging (MRI) Lesions During RCP
From Screening (Day -28) to Day 197
MRI lesionsNumber of NMOSD-related In-patient Hospitalizations During RCP
Day 1 (Baseline) through Day 197
RelapsesAnnualized AC-determined NMOSD Attack Rate During Any Exposure to Inebilizumab
For participants randomized to inebilizumab: Day 1 of RCP through end of OLP (approximately 3.5 years); and for participants randomized to placebo: Day 1 of OLP through the end of OLP (approximately 3
RelapsesSafetyNumber of Participants With Treatment Emergent Adverse Events (TEAEs) and Treatment Emergent Serious Adverse Events (TESAEs) During RCP
Day 1 (Baseline) through Day 197
SafetyNumber of Participants With TEAEs and TESAEs During OLP
Day 198 through end of OLP period (maximum of 3 years after the last participant entered, until regulatory approval or study discontinuation, whichever occurs first) (approximately 3 years)
SafetyNumber of Participants With TEAEs and TESAEs During SFP (Open-label Population)
Every 3 months for a total of 1 year after the last dose of study drug (approximately 3 years)
SafetyNumber of Participants With TEAEs and TESAEs During SFP (Non-OLP Population)
Every 3 months for a total of 1 year after the last dose of study drug (approximately 3 years)
SafetyNumber of Participants With at Least a 2-Grade Shift From Baseline to Worst Toxicity Grade in Hematology and Chemistry During RCP
Day 1 (Baseline) through Day 197
Who could take part
NMOSD · 18 and over
Inclusion Criteria: 1. Men and women 18 years or older with diagnosis of NMO/NMOSD 2. Confirmation of NMO/NMOSD status: 1. AQP4-IgG sero-positive NMO/NMOSD with at least one attack requiring rescue therapy in the last year or two attacks requiring rescue therapy in the last 2 years 2. AQP4-IgG sero-negative NMO with at least one attack requiring rescue therapy in the last year or two attacks requiring rescue therapy in the last 2 years 3. Able and willing to give written informed consent and comply with the requirements of the study protocol. 4. EDSS \<= 7.5 (8 in special circumstances) 5. Men and women of reproductive potential must agree to use a highly effective method of birth control from screening to 6 months after final dose of the investigational product. Exclusion Criteria: 1. Lactating and pregnant females 2. Treatment with any investigational agent within 4 weeks of screening 3. Known history of a severe allergy or reaction to any component of the investigational product formulation or history of anaphylaxis following any biologic therapy. 4. Known active severe bacterial, viral, or other infection or any major episode of infection requiring hospitalization. 5. History of alcohol, drug, or chemical abuse, or a recent history of such abuse \< 1 year prior to randomization 6. Receipt of the following at any time prior to randomization: 1. Alemtuzumab 2. Total lymphoid irradiation 3. Bone marrow transplant 4. T-cell vaccination therapy 7. Receipt of rituximab or any experimental B-cell depleting agent within 6 months prior screening and B-cells below the lower limit of normal. 8. Receipt of intravenous immunoglobulin (IVIG) within 1 month prior to randomization. 9. Receipt of any of the following within 3 months prior to randomization: 1. Natalizumab (Tysabri®). 2. Cyclosporin 3. Methotrexate 4. Mitoxantrone 5. Cyclophosphamide 6. Tocilizumab 7. Eculizumab 10. History of Hepatitis B and/or Hepatitis C (Hep B/C at screening) 11. Known history of a primary immunodeficiency (congenital or acquired) or an underlying condition such as human immunodeficiency virus (HIV) infection 12. History of malignancies, apart from squamous cell or basal cell carcinoma of the skin treated with documented success of curative therapy > 3 months prior to randomization 13. Any concomitant disease other than NMO/NMOSD that required treatment with oral or intravenous steroids at doses over 20 mg a day for over 21 days
As registered. Criteria can change, so ask the trial team or your neurologist.
About this trial
In the sponsor's words
To compare the efficacy of inebilizumab (MEDI-551) versus placebo in reducing the risk of an neuromyelitis optica/neuromyelitis optica- spectrum disorders (NMO/NMOSD) attack in participants with NMO/NMOSD.
Papers
Results
Efficacy of Inebilizumab in N-MOmentum Trial Participants With or Without Prior Immunosuppressants.Ann Clin Transl Neurol · 2026
Results
Safety and efficacy of inebilizumab for the treatment of neuromyelitis optica spectrum disorder: end-of-study results from the open-label period of the N-MOmentum trial.Lancet Neurol · 2024
Results
B cell and aquaporin-4 antibody relationships with neuromyelitis optica spectrum disorder activity.Ann Clin Transl Neurol · 2024
Results
Efficacy and safety of inebilizumab in Asian participants with neuromyelitis optica spectrum disorder: Subgroup analyses of the N-MOmentum study.Mult Scler Relat Disord · 2023
Results
Attack adjudication in neuromyelitis optica spectrum disorder: Substantiation of criteria by magnetic resonance imaging and biomarkers in N-MOmentum.Mult Scler · 2023
Results
Serum neurofilament light chain levels at attack predict post-attack disability worsening and are mitigated by inebilizumab: analysis of four potential biomarkers in neuromyelitis optica spectrum disorder.J Neurol Neurosurg Psychiatry · 2023
Results
Inebilizumab for treatment of neuromyelitis optica spectrum disorder in patients with prior rituximab use from the N-MOmentum Study.Mult Scler Relat Disord · 2022
Results
Association between B-cell depletion and attack risk in neuromyelitis optica spectrum disorder: An exploratory analysis from N-MOmentum, a double-blind, randomised, placebo-controlled, multicentre phase 2/3 trial.EBioMedicine · 2022
Results
Long-term efficacy and safety of inebilizumab in neuromyelitis optica spectrum disorder: Analysis of aquaporin-4-immunoglobulin G-seropositive participants taking inebilizumab for ⩾4 years in the N-MOmentum trial.Mult Scler · 2022
Results
Pharmacodynamic modelling and exposure-response assessment of inebilizumab in subjects with neuromyelitis optica spectrum disorders.Br J Clin Pharmacol · 2022
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History
Started
Apr 2015
Main results due
Oct 2018
Finished
Nov 2020
Results posted
Dec 2019
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