Phase III Study of Evobrutinib in RMS (EVOLUTION RMS 1)
What it found
The trial ended early for another reason (see below).
up to 156 weeks
| Group | n | Value |
|---|---|---|
| evobrutinib | 560 | 0.15 (95% CI 0.12-0.18) |
| teriflunomide | 564 | 0.14 (0.11-0.18) |
adjusted rate ratio 1.02
p = 0.55
Total participants: 1124
Read by software from the paper's abstract
Reason given: Primary analysis of the RMS phase 3 study (MS200527\_0080) resulted in the early termination of the study.
What was tested
Treatment tested
- Evobrutinib
Tyrosine-protein kinase BTK inhibitor
Compared with
- Teriflunomide
Dihydroorotate dehydrogenase inhibitor
Results by group
Double Blind Treatment Period (DBTP) and Double Blind Extension (DBE) Period: Annualized Relapse Rate (ARR)
From baseline to 172 weeks
| Group | Value | Interval | Number analysed |
|---|---|---|---|
| Teriflunomide | 0.13 relapses per year | 0.11–0.15 | 564 |
| Evobrutinib | 0.14 relapses per year | 0.12–0.16 | 560 |
Teriflunomide
Evobrutinib
Open Label Extension (OLE) Period: Number of Participants With Adverse Events (AEs) and Serious AEs
From OLE Baseline (DBTP Week 96) to OLE Week 52
| Group | Value | Interval | Number analysed |
|---|---|---|---|
| Evobrutinib | 1 Participants | 3 | |
| Evobrutinib | 0 Participants | 3 |
Evobrutinib
Evobrutinib
Values as posted on ClinicalTrials.gov. Outcomes measured differently across trials are not directly comparable.
Safety
| Group | Participants at risk | Serious adverse events | Deaths |
|---|---|---|---|
| Teriflunomide | 563 | 33 (5.9%) | 1 |
| Evobrutinib | 559 | 45 (8.1%) | 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
Double Blind Treatment Period (DBTP) and Double Blind Extension (DBE) Period: Annualized Relapse Rate (ARR)
From baseline to 172 weeks
RelapsesSafetyOpen Label Extension (OLE) Period: Number of Participants With Adverse Events (AEs) and Serious AEs
From OLE Baseline (DBTP Week 96) to OLE Week 52
SafetyFor DBTP: ARR based on qualified relapses up to 156 weeks in participants with RMS
Relapses
Other measures (43)
DBTP and DBE Period: Percentage of Participants Without 12-Week Confirmed Disability Progression (CDP) as Measured by Expanded Disability Status Scale (EDSS)
Week 96 and Week 156 (combined DBTP and DBE period)
Disability progressionDBTP and DBE Period: Percentage of Participants Without 24-Week Confirmed Disability Progression (CDP) as Measured by Expanded Disability Status Scale (EDSS)
Week 96 and Week 156 (combined DBTP and DBE periods)
Disability progressionDBTP and DBE Period: Percentage of Participants With 24-Week Confirmed Disability Improvement (CDI) as Measured by Expanded Disability Status Scale (EDSS)
Week 96 and Week 156 (combined DBTP and DBE periods)
Disability progressionDBTP and DBE Period: Change From Baseline in Patient Reported Outcomes Measurement Information System (PROMIS) Physical Function (PF) Score at Week 48, Week 96, Week 120, Week 144 and Week 156
Baseline, Week 48, Week 96, Week 120, Week 144 and Week 156 (combined DBTP and DBE periods)
Quality of life (reported by participants)DBTP and DBE Period: Change From Baseline in Patient Reported Outcomes Measurement Information System (PROMIS) Fatigue Score at Week 48, Week 96, Week 120, Week 144 and Week 156
Baseline, Week 48, Week 96, Week 120, Week 144 and Week 156 (combined DBTP and DBE periods)
FatigueQuality of life (reported by participants)DBTP and DBE Period: Total Number of T1 Gadolinium-positive (Gd+) Lesions
From baseline to 176 weeks
MRI lesionsDBTP and DBE Period: New or Enlarging T2 Lesions Rate
From baseline to 176 weeks
MRI lesionsDBTP Period: Neurofilament Light Chain Concentration (NfL) at Week 12
Week 12
Blood or spinal fluid markersDBTP and DBE Periods: Number of Participants With Treatment-Emergent Adverse Events (TEAEs) and Adverse Events of Special Interest (AESIs)
From baseline to 176 weeks
SafetyDBTP and DBE Periods: Number of Participants With Treatment-Emergent Adverse Events (TEAEs) by Severity
From baseline to 176 weeks
Safety
Who could take part
Relapsing and progressive · 18 to 55
Inclusion Criteria: * Participants are diagnosed with RMS (relapsing-remitting multiple sclerosis [RRMS] or secondary progressive multiple sclerosis [SPMS] with relapses) in accordance with 2017 Revised McDonald criteria (Thompson 2018) * Participants with one or more documented relapses within the 2 years before Screening with either: a. one relapse which occurred within the last year prior to randomization, OR b. the presence of at least 1 gadolinium-enhancing (Gd+) T1 lesion within 6 months prior to randomization * Participants have Expanded Disability Status Scale (EDSS) score of 0 to 5.5 at Screening and Baseline (Day 1). Participants with an EDSS score \<= 2 at Screening and Baseline (Day 1) are only eligible for participation if their disease duration (time since onset of symptoms) is no more than 10 years * Participants are neurologically stable for >= 30 days prior to both screening and baseline (Day 1) * Female participants must be neither pregnant nor breast-feeding or must lack child-bearing potential (as defined by either: post-menopausal or surgically sterile), or use an effective method of contraception for the duration of the study and at least 2 years after study intervention due to the long elimination period for teriflunomide of 2 years, unless the participant undergoes an accelerated elimination procedure * Male participants must refrain from donating sperm and/or abstain from intercourse with women of child-bearing potential or use an effective method of contraception for the duration of the study and at least 2 years after study intervention due to the long elimination period for teriflunomide of 2 years, unless the participant undergoes an accelerated elimination procedure * Participants have given written informed consent prior to any study-related procedure * Other protocol defined inclusion criteria could apply. Exclusion Criteria: * Participants diagnosed with Progressive MS, in accordance with the 2017 Revised McDonald criteria as follows: a). Participants with Primary Progressive MS. b). Participants with secondary progressive MS without evidence of relapse * Disease duration more than (>) 10 years in participants with an EDSS =\< 2.0 at screening and Baseline (Day 1) * Immunologic disorder other than MS, or any other condition requiring oral, intravenous (IV) , intramuscular, or intra-articular corticosteroid therapy, with the exception of well-controlled Type 2 diabetes mellitus or well controlled thyroid disease * Other protocol defined exclusion criteria could apply.
As registered. Criteria can change, so ask the trial team or your neurologist.
About this trial
In the sponsor's words
The study is to evaluate the efficacy and safety of evobrutinib administered orally twice daily versus Teriflunomide (Aubagio®), administered orally once daily in participants with Relapsing Multiple Sclerosis (RMS). Participants who complete the double-blind treatment period (DBTP) and double-blind extension period (DBEP) prior to approval of a separate long-term follow-up study in their country will get an option for evobrutinib treatment continuation through a 96-week open-label extension (OLE) period.
Papers
Results
First-in-Human Safety, Tolerability, Pharmacokinetics, and Pharmacodynamics of Single and Multiple Ascending Oral Doses of BIIB091, an Oral BTK Inhibitor, in Healthy Adult Participants.Drug Des Devel Ther · 2026
Results
Effect of Evobrutinib on Slowly Expanding Lesion Volume in Relapsing Multiple Sclerosis: A Post Hoc Analysis of a Phase 2 Trial.Neurology · 2024
Results
Safety and efficacy of evobrutinib in relapsing multiple sclerosis (evolutionRMS1 and evolutionRMS2): two multicentre, randomised, double-blind, active-controlled, phase 3 trials.Lancet Neurol · 2024
Annualised relapse rate was 0·15 (95% CI 0·12-0·18 with evobrutinib vs 0·14 [0·11-0·18] with teriflunomide (adjusted RR 1·02 [0·75-1·39]; p=0·55) in evolutionRMS1 and 0·11 (0·09-0·13 vs 0·11 [0·09-0·13]; adjusted RR 1·00 [0·74-1·35]; p=0·51) in evolutionRMS2.
Read by software from the paper's abstract
Results
Characterisation of the safety profile of evobrutinib in over 1000 patients from phase II clinical trials in multiple sclerosis, rheumatoid arthritis and systemic lupus erythematosus: an integrated safety analysis.J Neurol Neurosurg Psychiatry · 2023
Results
Determination of a clinically effective evobrutinib dose: Exposure-response analyses of a phase II relapsing multiple sclerosis study.Clin Transl Sci · 2022
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History
Started
Jun 2020
Main results due
Oct 2023
Finished
Mar 2024
Results posted
Jun 2025
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