Janssen has submitted an application to the European Medicines Agency (EMA) asking that ponesimod be approved as an oral treatment for adults with relapsing multiple sclerosis (MS) in the European Union.
Ponesimod (formerly ACT-128800) is an experimental treatment that targets the sphingosine-1-phosphate receptor 1 (S1P1), and reportedly with high selectivity. In doing so, it works to ‘trap’ immune cells in lymph nodes, limiting the damage they can do to the nervous system.
The company’s Marketing Authorisation Application for ponesimod is based on data from the Phase 3 clinical trial OPTIMUM (NCT02425644). In this trial, 1,133 people with relapsing-remitting MS (RRMS) or active secondary progressive MS (SPMS) were randomly assigned to either ponesimod at 20 mg or Aubagio (teriflunomide) at 14 mg, both taken by mouth once a day for two years (108 weeks).
Topline results from OPTIMUM showed that the annualized relapse rate (ARR) was significantly reduced by 30.5% with ponesimod, as compared to Aubagio, treatment — on average, 0.202 relapses per year in the ponesimod group and 0.290 among those given Aubagio.
A significant reduction (56%) in the number of new active, inflammatory brain lesions visible on a magnetic resonance imaging (MRI) scan was also seen with ponesimod treatment, as compared to Aubagio. There was also a trend towards lesser disability progression with ponesimod, but this did not reach statistical significance.
Ponesimod did lead to a statistically significant reduction in reported fatigue relative to Aubagio.
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