AFFINITY
What it found
The trial was stopped early because the treatment was not working.
Reason given: The top-line results from the Part 1 did not meet the pre-specified primary endpoint nor the key secondary endpoints. The decision to discontinue study 215MS202 Part 2 was not based on safety concerns.
What was tested
Treatment tested
- Opicinumab
Leucine-rich repeat and immunoglobulin-like domain-containing nogo receptor-interacting protein 1 inhibitor
Placebo or sham
- Placebo
Results by group
Part 1: Overall Response Score
Part 1: Baseline to Week 72
| Group | Value | Interval | Number analysed |
|---|---|---|---|
| Part 1: Placebo | -0.04 score on a scale | -0.18–0.11 | 131 |
| Part 1: BIIB033 750 mg | 0.11 score on a scale | -0.03–0.25 | 132 |
Part 1: Placebo
Part 1: BIIB033 750 mg
p = 0.1479; Treatment Difference 0.15 (95% CI -0.05–0.35)
Part 2: Number of Participants Experiencing Adverse Events (AEs) and Serious Adverse Events (SAEs)
Part 2: Baseline to Week 169
| Group | Value | Interval | Number analysed |
|---|---|---|---|
| Part 2: Placebo to BIIB033 750 mg | 71 Participants | 100 | |
| Part 2: BIIB033 750 mg | 76 Participants | 113 | |
| Part 2: Placebo to BIIB033 750 mg | 9 Participants | 100 | |
| Part 2: BIIB033 750 mg | 2 Participants | 113 |
Part 2: Placebo to BIIB033 750 mg
Part 2: BIIB033 750 mg
Part 2: Placebo to BIIB033 750 mg
Part 2: BIIB033 750 mg
Values as posted on ClinicalTrials.gov. Outcomes measured differently across trials are not directly comparable.
Safety
| Group | Participants at risk | Serious adverse events | Deaths |
|---|---|---|---|
| Part 1: Placebo | 131 | 6 (4.6%) | 0 |
| Part 1: BIIB033 750 mg | 132 | 9 (6.8%) | 1 |
| Part 2: Placebo to BIIB033 750 mg | 100 | 9 (9.0%) | 0 |
| Part 2: BIIB033 750 mg | 113 | 2 (1.8%) | 0 |
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
Part 1: Overall Response Score
Part 1: Baseline to Week 72
Disability progressionWalking and mobilityPart 2: Number of Participants Experiencing Adverse Events (AEs) and Serious Adverse Events (SAEs)
Part 2: Baseline to Week 169
SafetyPart 1:
Other measures (17)
Part 1: Percentage of Participants With 12-week Confirmed Improvement in at Least 1 of the Following Assessments: EDSS, T25FW, 9HPT-D, or 9HPT-ND
Part 1: Baseline to Week 72
Disability progressionWalking and mobilityArm and hand functionPart 1: Percentage of Participants With 12-week Confirmed Improvement in at Least 1 of the Following Assessments: EDSS, T25FW, 9HPT-D, 9HPT-ND, or 3-Second Paced Auditory Serial Addition Test (PASAT-3)
Part 1: Baseline to Week 72
Disability progressionThinking and memoryWalking and mobilityArm and hand functionPart 1: Percentage of Participants With 12-week Confirmed Improvement in at Least 1 of the Following Assessments: EDSS, T25FW, 9HPT-D, or 9HPT-ND, and Without Confirmed Worsening in Any of the 4 Assessments During the 72 Weeks of the Study
Part 1: Baseline to Week 72
Disability progressionWalking and mobilityArm and hand functionPart 1: Percentage of Participants With 12-week Confirmed Improvement in at Least 1 of the Following Assessments: EDSS, T25FW, 9HPT-D, 9HPT-ND, and Symbol Digit Modalities Test (SDMT)
Part 1: Baseline to Week 72
Disability progressionThinking and memoryWalking and mobilityArm and hand functionPart 1: Percentage of Participants With 12-week Confirmed Improvement in at Least 1 of the Following Assessments: EDSS, T25FW, 9HPT-D, or 9HPT-ND (20% Thresholds for T25FW and 9HPT)
Part 1: Baseline to Week 72
Disability progressionWalking and mobilityArm and hand functionPart 2: Overall Response Score
Part 2: Baseline to Week 96
Part 2: Percentage of Participants With 24-week Confirmed Improvement in at Least 1 of the Following Assessments: EDSS, T25FW, 9HPT-D, or 9HPT-ND
Part 2: Baseline to Week 108
Disability progressionPart 2: Percentage of Participants With 24-week Confirmed Improvement in at Least 1 of the Following Assessments: EDSS, T25FW, 9HPT-D, 9HPT-ND, or PASAT-3
Part 2: Baseline to Week 108
Disability progressionThinking and memoryPart 2: Percentage of Participants With 24-week Confirmed Improvement in at Least 1 of the Following Assessments: EDSS, T25FW, 9HPT-D, or 9HPT-ND, and Without Confirmed Worsening in Any of the 4 Assessments During the 96 Weeks of the Study
Part 2: Baseline to Week 96
Disability progressionPart 2: Percentage of Participants With 24-week Confirmed Improvement in at Least 1 of the Following Assessments: EDSS, T25FW, 9HPT-D, 9HPT-ND, and SDMT
Part 2: Baseline to Week 108
Disability progressionThinking and memory
Who could take part
Relapsing and progressive · 18 to 58
Key Inclusion Criteria: Part 1 * Baseline Expanded Disability Status Scale (EDSS) of 2.0 to 6.0, have a diagnosis of relapsing-remitting multiple sclerosis (RRMS) per the 2010 McDonald's criteria or onset of secondary progressive multiple sclerosis (SPMS) per the Lublin and Reingold criteria, and should have experienced their first MS symptom(s) within the previous 20 years. * Subjects must have experienced at least 1 of the following within 24 months prior to Day 1/Baseline: a clinical relapse (but not within 24 weeks prior to Day 1/Baseline), gadolinium-enhancing lesions on brain or spinal cord magnetic resonance imaging (MRI), or new T2 lesion(s) on brain or spinal cord MRI. * Subjects must be on a stable dose of a protocol-specified anti-inflammatory disease-modifying therapy (DMT) (IFNβ [Avonex, Plegridy, Betaferon/Betaseron, or Rebif], dimethyl fumarate (DMF) [Tecfidera], or natalizumab [Tysabri]) for at least 24 weeks prior to enrollment. * In addition, subjects must have met protocol-defined MRI characteristics using magnetization transfer ratio (MTR) and diffusion tensor imaging (DTI) sequences at Screening/Baseline. Key Inclusion Criteria: Part 2 -Subjects who complete study treatment (BIIB033 or placebo) at Part 1/Week 72 Visit. Key Exclusion Criteria: Part 1 * Primary progressive MS * An MS relapse that has occurred within 24 weeks prior to Day 1/Baseline or the subject has not stabilized from a previous relapse at the time of Screening. * Treatment with any chemotherapeutic agents (e.g., mitoxantrone, cyclophosphamide, cladribine), cell-depleting monoclonal antibodies (mAbs) (e.g., rituximab, ocrelizumab, alemtuzumab), total lymphoid irradiation, T-cell or T-cell receptor vaccination, or teriflunomide within 1 year prior to Day 1/Baseline. * Treatment with other anti-inflammatory DMTs (e.g., GA, fingolimod, daclizumab) or plasmapheresis within 24 weeks prior to Day1/Baseline. * Treatment with Botox for limb spasticity within 24 weeks before Day 1/Baseline. * Contraindications to MRI, for example, presence of pacemakers or other implanted metal devices (excluding dental braces), an allergy to gadolinium renal impairment, or claustrophobia that cannot be medically managed. * History of human immunodeficiency virus or other immunodeficient conditions. * History of malignancy; however, subjects with a history of excised or treated basal cell carcinoma or fewer than 3 squamous cell carcinomas are eligible to participate in this study. Key Exclusion Criteria: Part 2 * Subjects who did not complete study treatment in Part 1/Week 72 Visit * Subjects who have a duration >12 weeks between their Part 1/Week 72 Visit and Part 2/Day 1. * Contraindications to MRI, for example, presence of pacemakers or other implanted metal devices (excluding dental braces), an allergy to Gd, renal impairment, or claustrophobia that cannot be medically managed. * History of human immunodeficiency virus or other immunodeficient conditions not related to DMT treatment. * History of malignancy unless enrollment is approved by the Sponsor; subjects with a history of excised or treated basal cell carcinoma or fewer than 3 squamous cell carcinomas are eligible to participate in this study. 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
The primary objective of Part 1 of this study is to evaluate the effects of BIIB033 versus placebo on disability improvement over 72 weeks. The primary objective of Part 2 of this study is to evaluate the long-term safety profile of BIIB033 as an add-on therapy in participants with MS. The secondary objective of Part 1 is to evaluate the effects of BIIB033 versus placebo on additional measures of disability improvement. The secondary objective of Part 2 is to investigate long-term efficacy (disability improvement) and additional safety measures of BIIB033 as an add-on therapy in participants with MS.
Papers
Results
Safety and efficacy of opicinumab in participants with relapsing multiple sclerosis (AFFINITY Part 1): A randomized, controlled, phase 2 trial.Mult Scler · 2026
Results
Patterning Chronic Active Demyelination in Slowly Expanding/Evolving White Matter MS Lesions.AJNR Am J Neuroradiol · 2020
Results
Elliott C, Rudko DA, Arnold DL, Fetco D, Elkady AM, Araujo D, Zhu B, Gafson A, Tian Z, Belachew S, Bradley DP, Fisher E. Lesion-level correspondence and longitudinal properties of paramagnetic rim and slowly expanding lesions in multiple sclerosis. Mult Scler. 2023 May;29(6):680-690. doi: 10.1177/13524585231162262. Epub 2023 Apr 10.Results
Hanf KJM, Arndt JW, Liu Y, Gong BJ, Rushe M, Sopko R, Massol R, Smith B, Gao Y, Dalkilic-Liddle I, Lee X, Mojta S, Shao Z, Mi S, Pepinsky RB. Functional activity of anti-LINGO-1 antibody opicinumab requires target engagement at a secondary binding site. MAbs. 2020 Jan-Dec;12(1):1713648. doi: 10.1080/19420862.2020.1713648.
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History
Started
Nov 2017
Main results due
Feb 2021
Finished
Feb 2021
Results posted
Apr 2022
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