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dimethyl

Phase 3

Multiple Sclerosis, Relapsing-Remitting | Small molecule | Neurology |Biogen Inc.|Last Updated: May 19, 2026

Target and mechanism

Molecular targetKEAP1
Target classInhibitor
ModalitySmall molecule

Also known as Dimethyl Fumarate

Success Probability

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Market & Valuation

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Trial Design

UNCONTROLLEDDMC
Total Trials4
Total Enrollment481

FDA Designations

No designations recorded

Clinical trial landscape

dimethyl · 12 trials · 6 indications

Phase 3 6Phase 2 4Phase 1 2
NCT02555215Extension Study of BG00012 in Pediatric Subjects With Relapsing Remitting Multiple Sclerosis (RRMS)Multiple Sclerosis, Relapsing-Remitting
COMPLETED20 Analytics
NCT02525874Effect of BG00012 on Lymphocyte Subsets and Immunoglobulins in Subjects With Relapsing Remitting Multiple Sclerosis (RRMS).Multiple Sclerosis, Relapsing-Remitting
COMPLETED218 Analytics
NCT02283853Phase 3 Efficacy and Safety Study of BG00012 in Pediatric Participants With Relapsing-Remitting Multiple Sclerosis (RRMS)Relapsing-Remitting Multiple Sclerosis
COMPLETED156 Analytics
NCT02579681Study Assessing Cognition in Relapsing Remitting Multiple Sclerosis (RRMS) Patients Treated With BG00012Multiple Sclerosis, Relapsing-Remitting
COMPLETED221 Analytics
NCT01838668An Efficacy and Safety Study of BG00012 (Dimethyl Fumarate) in Asian Subjects With Relapsing Remitting Multiple Sclerosis (RRMS)Relapsing-Remitting Multiple Sclerosis
COMPLETED225 Analytics
NCT00835770BG00012 Monotherapy Safety and Efficacy Extension Study in Multiple Sclerosis (MS)Relapsing-Remitting Multiple Sclerosis
COMPLETED1,736 Analytics
PHASE3COMPLETED
Extension Study of BG00012 in Pediatric Subjects With Relapsing Remitting Multiple Sclerosis (RRMS)
Multiple Sclerosis, Relapsing-RemittingUnlock trial analytics
PHASE3COMPLETED
Effect of BG00012 on Lymphocyte Subsets and Immunoglobulins in Subjects With Relapsing Remitting Multiple Sclerosis (RRMS).
Multiple Sclerosis, Relapsing-RemittingUnlock trial analytics
PHASE3COMPLETED
Phase 3 Efficacy and Safety Study of BG00012 in Pediatric Participants With Relapsing-Remitting Multiple Sclerosis (RRMS)
Relapsing-Remitting Multiple SclerosisUnlock trial analytics
PHASE3COMPLETED
Study Assessing Cognition in Relapsing Remitting Multiple Sclerosis (RRMS) Patients Treated With BG00012
Multiple Sclerosis, Relapsing-RemittingUnlock trial analytics
PHASE3COMPLETED
An Efficacy and Safety Study of BG00012 (Dimethyl Fumarate) in Asian Subjects With Relapsing Remitting Multiple Sclerosis (RRMS)
Relapsing-Remitting Multiple SclerosisUnlock trial analytics
PHASE3COMPLETED
BG00012 Monotherapy Safety and Efficacy Extension Study in Multiple Sclerosis (MS)
Relapsing-Remitting Multiple SclerosisUnlock trial analytics

Study Endpoints

Primary Endpoints

Number of Participants With Adverse Events (AEs) and Serious Adverse Events (SAEs)
Baseline to Week 96

An AE is any untoward medical occurrence that does not necessarily have a causal relationship with treatment. An SAE is any untoward medical occurrence that at any dose: results in death; in the view of the Investigator, places the participant at immediate risk of death (a life-threatening event); requires inpatient hospitalization or prolongation of existing hospitalization; results in persistent or significant disability/incapacity; results in a congenital anomaly/birth defect; any other medically important event that, in the opinion of the Investigator, may jeopardize the participant or may require intervention to prevent one of the other outcomes listed in the definition above.

Number of Participants Discontinuing Treatment Due to an Adverse Event
Baseline to Week 96

An AE is any untoward medical occurrence that does not necessarily have a causal relationship with treatment.

Change From Baseline in Lymphocyte Subsets Counts up to 48 Weeks: T Cell, B Cell, Natural Killer Cell (TBNK)
Baseline, Week 4, Week 8, Week 12, Week 24, Week 36 and Week 48

Lymphocyte subsets include T cell, B cell and Natural killer (NK) cells.

Change From Baseline in Lymphocyte Subsets Counts up to 48 Weeks: T-Cells Subsets
Baseline, Week 4, Week 8, Week 12, Week 24, Week 36 and Week 48

T-cells subsets includes Activated CD4+ T-cell, Activated CD8+ T-cell, Activated CD8+ T-cell \[CD38+\], Activated Th (T helper) 1 phenotype, Activated Th17 phenotype, Activated Th2-enriched phenotype, Activated CD4+ T-cell \[CD38+HLA-DR+\], Activated CD4+ T-cell \[HLA-DR+\], Activated CD8+ T-cell \[HLA-DR+\], Central Memory (CM) CD4+ T-cell \[CD45RA-CCR7+\], CM CD4+ T-cell \[CD45RA-CCR7+\], CM CD8+ T-cell \[CD45RA-CCR7+\], Effector CD4+ T-cell \[CD45RA+CCR7-\], Effector CD8+ T-cell \[CD45RA+CCR7-\], Effector Memory (EM) CD4+ T-cell \[CD45RA-CCR7-\], EM CD8+ T-cell \[CD45RA-CCR7-\], Effector Regulatory T-cells, Effector CD4+ T-cell \[CD45RA+CCR7-\], Effector CD8+ T-cell \[CD45RA+CCR7-\], Naïve CD4+ T-cell \[CD45RA+\], Naïve CD8+ T-cell \[CD45RA+\], Naïve (N) CD8+ T-cell \[CD45RA+\], Naïve Regulatory T-cells, Terminal Effector Regulatory T-cells, Th1 phenotype, Th17 phenotype, Th2-enriched phenotype. Here, Change at week is represented as CW.

Change From Baseline in Lymphocyte Subsets Counts up to 48 Weeks: B-Cell Subsets
Baseline, Week 4, Week 8, Week 12, Week 24, Week 36 and Week 48

B-cell subsets include CD10+ Transitional B cells, CD138+ Plasma Cells, Ig (Immunoglobulin) D+ Memory B cells \[non-class switched\], IgD- Memory B cells \[class switched\], Naïve B cells, Plasma Cells \[CD10-\], Transitional B-cells and Plasmablasts. Here, Change at week is represented as CW.

Change From Baseline in Lymphocyte Subsets Counts up to 48 Weeks: Myeloid and Natural Killer (NK) Cells
Baseline, Week 4, Week 8, Week 12, Week 24, Week 36 and Week 48

Myeloid and natural killer cell subsets include CD56Bright NK cells, CD56Dim NK cells, Classical Monocytes, Myeloid dendritic cells, Non-classical Monocytes, Plasmacytoid dendritic cells, Total dendritic cells and Total monocytes \[CD14+\].

Change From Baseline in Lymphocyte Subsets Counts up to 48 Weeks: T-Cell Cytokines
Baseline, Week 4, Week 8, Week 12, Week 24, Week 36 and Week 48

T-cell cytokine subsets include IFN (interferon) g+ (% of CD4+ T cells), IFNg+ (% of CD8+ T cells), IFNg+ (% of memory CD4+ T cells), IFNg+ (% of memory CD8+ T cells), IL- (interleukin) 17A+/IFNg- (% of CD4+ T cells), IL-17A+/IFNg- (% of CD8+ T cells), IL-17A+/IFNg- (% of memory CD4+ T cells), IL-17A+/IFNg- (% of memory CD8+ T cells), IL-2+ (% of CD4+ T cells), IL-2+ (% of CD8+ T cells), IL-2+ (% of memory CD4+ T cells), IL-2+ (% of memory CD8+ T cells), IL-4+ (% of CD4+ T cells), IL-4+ (% of CD8+ T cells), IL-4+ (% of memory CD4+ T cells) and IL-4+ (% of memory CD8+ T cells). Here, Change at week is represented as CW.

Change From Baseline in Lymphocyte Subsets Counts up to 48 Weeks: Very Late Antigen-4 (VLA-4/Lymphocyte Function-Associated Antigen-1 (LFA-1) Antigen
Baseline, Week 4, Week 8, Week 12, Week 24, Week 36 and Week 48

VLA-4/LFA-1 antigen subsets include CD11a+ (% of B cells), CD11a+ (% of T cells), CD11a+ (% of MNC), CD11a+ (% of dendritic cells \[CD11c++\]), CD11a+ (% of lymphocytes), CD11a+ (% of monocytes), CD11a+ (% of neutrophils), CD49d+ (% of B cells), CD49d+ (% of T cells), CD49d+ (% of MNC), CD49d+ (% of dendritic cells \[CD11c++\]), CD49d+ (% of lymphocytes), CD49d+ (% of monocytes) and CD49d+ (% of neutrophils).

Part 1: Proportion of Participants Free of New or Newly Enlarging T2 Hyperintense Lesions on Brain Magnetic Resonance Imaging (MRI) Scans
At Week 96

Participants who were free of new or newly enlarging T2 hyperintense lesions were assessed on Brain MRI scans.

Part 2: Number of Participants With Treatment Emergent Adverse Events (TEAEs) and Treatment Emergent Serious Adverse Events (TESAEs)
From Week 96 up to last follow-up visit (up to Week 340)

An adverse event (AE) was any unfavorable and unintended sign (including an abnormal assessment such as an abnormal laboratory value), symptom, or disease temporally associated with the use of a medicinal (investigational) product, whether or not related to the medicinal (investigational) product. An SAE was any untoward medical occurrence that at any dose resulted in death, in the view of the Investigator, placed the participant at immediate risk of death, required inpatient hospitalization or prolongation of existing hospitalization, resulted in persistent or significant disability/incapacity, resulted in a birth defect. TEAEs were defined as AEs occurring or worsening after beginning study treatment (after the first dose).

Part 2: Number of Participants Who Discontinued Study Treatment Due to an AE
From Week 96 up to last follow-up visit (up to Week 340)

An AE was any unfavorable and unintended sign (including an abnormal assessment such as an abnormal laboratory value), symptom, or disease temporally associated with the use of a medicinal (investigational) product, whether or not related to the medicinal (investigational) product.

Proportion of patients with worsening in cognitive improvement over 2 years.
Up to 2 years

As measured by at least 2 standard deviation (SD) below Italian normative data of the Rao's Brief Repeatable Battery of Neuropsychological Tests (BRB) and a 100-item version of the Stroop Test. The Brief Repeatable Battery of Neuropsychological Tests (BRB-N) is a sensitive measure of cognitive impairment in multiple sclerosis (MS) patients. The Stroop Test is a test used to measure a person's sustained attention for word reading and color naming with and without interference.

Total number of new Gadolinium-enhancing lesions over 4 scans at Weeks 12, 16, 20, and 24.
Part I (Week 24)
Incidence of treatment-emergent adverse events and serious adverse events
Part II (Up to 4.5 years)
Number of Participants With Treatment-Emergent Adverse Events (AEs)
Day 1 up to Week 561

An adverse event (AE) is any untoward medical occurrence in a participant or clinical investigation participant administered a pharmaceutical product and which does not necessarily have a causal relationship with this treatment.

Neurofilament light chain in the cerebrospinal fluid (CSF)
0-48 weeks

CSF Neurofilament Light Chain (NFL) is measured twice over a course of 48 weeks. Patients will have a spinal tap performed at baseline and again at week 48.

Change in the Number of New or Newly Enlarging T2 Hyperintense Lesions on Brain Magnetic Resonance Imaging (MRI) Scans From the Baseline Period to On-Treatment Assessment Period
Baseline Period (Week -8 to Day 0), On-Treatment Assessment Period (Week 16 to Week 24)
Percentage of Tetanus Responders (≥ 2-Fold Rise) at Day 28 Compared to Prevaccination Level
Up to Week 4 (Day 28) postvaccination

Percentage of participants with a ≥ 2-fold rise in anti-tetanus serum immunoglobulin G (IgG) levels (responders) from prevaccination to 4 weeks after Td vaccination.

Summary of Treatment-emergent Adverse Events (TEAEs) Occurring Post-BG00012 Dosing (Add-on Therapy Period)
AEs were collected from enrollment until the final study visit (Week 26 +/-5 days).

An AE was any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease temporally associated with the use of the study drug, whether or not related to the study drug. A serious adverse event (SAE) was any untoward medical occurrence that, at any dose: resulted in death; in the view of the Investigator, placed the participant at immediate risk of death (a life-threatening event); required inpatient hospitalization or prolongation of existing hospitalization; resulted in persistent or significant disability/incapacity; resulted in a congenital anomaly/birth defect; was any other medically important event that, in the opinion of the Investigator, jeopardized the participant or required intervention to prevent one of the other outcomes above. TEAE was defined as having an onset date that was on or after the start of study treatment (BG00012), or that worsened after the start of study treatment.

Potentially Clinically Significant Hematology Laboratory Abnormalities for Combination Therapy
collected from the start of BG00012 administration through to Week 26 +/- 5 days

Percentage of participants with potentially clinically significant hematology laboratory abnormalities.

Maximum Post-Baseline Values: Liver Enzymes for Combination Therapy
collected from the start of BG00012 administration through to Week 26 +/- 5 days

Percentage of participants with post-baseline liver enzyme values above the upper limit of normal (ULN). Liver enzymes included alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transpeptidase (GGT), and bilirubin. Elevated ALT/AST (ALT/AST ≥ 3\*ULN) concurrent with elevated total bilirubin was also evaluated.

Worst Post-Baseline Values for Selected Urinalysis Parameters That Require Further Evaluation for Combination Therapy
collected from the start of BG00012 administration through to Week 26 +/- 5 days

Percentage of participants with post-baseline values for selected urinalysis parameters requiring further evaluation. For urine microscopy, results were categorized for male and female participants. For males, normal/negative was considered 0 to 3 red blood cells/high-power field (rbc/hpf), and positive was categorized in the following stages: 4 to 10, 11 to 20, 21 to 149, and ≥ 150 rbc/hpf. For females, normal/negative was considered 0 to 8 rbc/hpf, and positive was categorized in the following stages: 9 to 20, 21 to 30, 31 to 149, and ≥ 150 rbc/hpf.

The maximum observed concentration: Cmax
Up to week 9
The time to reach maximum observed concentration: Tmax
Up to week 9
The area under the plasma concentration versus time curve from time zero to 24 hours
Up to week 9
The area under the plasma concentration versus time curve from time zero to time t (the last sampling time with quantifiable monomethyl fumarate [MMF])
Up to week 9
The area under the plasma concentration versus time curve from time zero to infinity
Up to week 9
The apparent elimination half-life
Up to week 9
The time prior to the first quantifiable monomethyl fumarate (MMF) plasma concentration
Up to week 9
Area under the plasma concentration versus time curve (AUC) ratio of test regimens compared with reference for Part 1
Up to week 9
Area under the plasma concentration versus time curve (AUC) ratio of test regimens compared with reference for Part 2
Up to week 9
• incidence of treatment emergent AEs
11 days
• incidence of serious AEs (SAEs)
11 days
• clinical laboratory assessments:
11 days
• Concentration versus time data for BG00012 (as measured by monomethyl fumarate (MMF), will be collected for each treatment group. Plasma PK parameters will include AUC, Cmax, time to maximum plasma concentration, half life & lagtime.
11 days

Secondary Endpoints

Total Number of New or Newly Enlarging T2 Hyperintense Lesions From Week 16 to Week 24
Week 16 to Week 24
Total Number of New or Newly Enlarging T2 Hyperintense Lesions From Week 64 to Week 72
Week 64 to Week 72
Average Annualized Relapse Rate (ARR)
Baseline to Week 96
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Study Design & Arms

AllocationNA
MaskingNONE
ModelSINGLE_GROUP
PurposeTREATMENT

Treatment Arms

ArmTypeDescription
dimethyl fumarateEXPERIMENTALParticipants will receive 120 mg capsule(s) taken orally.
BG00012EXPERIMENTALParticipants will receive the recommended dose of 240 mg orally, twice a day
IFN β-1a (Avonex)ACTIVE_COMPARATORParticipants will receive the recommended dose of 30 μg (weekly)
Part I PlaceboPLACEBO_COMPARATORPlacebo orally twice a day. In Part I: participants will be randomized into one of 2 groups: BG00012, 240 mg twice daily (BID) or matching placebo BID Participants will begin the study by taking 1 capsule orally BID for first 7 days and escalate their dosing from day 8 to 2 matching capsules orally BID.
Part I BG00012EXPERIMENTALBG00012 240 mg orally twice a day (participants will begin dosing at 120 mg BG00012 twice daily (BID) for the first 7 days and 240 mg BG00012 BID thereafter.) In Part I: participants will be randomized into one of 2 groups: BG00012, 240 mg twice daily (BID) or matching placebo BID
Part II BG00012EXPERIMENTALPart II: All participants will receive BG00012 240 mg orally twice a day (participants will begin dosing at 120 mg (1 capsule) BG00012 twice daily (BID) for the first 7 days and 240 mg (2 capsules) BG00012 BID thereafter.
BG00012 plus placeboEXPERIMENTALIn the first phase, participants will receive BG00012 240 mg (two 120 mg capsules) twice a day (BID) and 2 placebo capsules once a day. In the second phase participants will receive open-label BG00012 240 mg BID, for atleast 8 years.
Active drugACTIVE_COMPARATORDimethyl fumarate, 240mg twice daily for 48 weeks
PlaceboPLACEBO_COMPARATORPlacebo Oral Capsules, 2 tablets twice daily for 48 weeks
Non-Pegylated IFN Treated Plus VaccinationsACTIVE_COMPARATORParticipants on a stable approved dose of a non pegylated IFN for ≥3 months will receive 3 vaccinations on Day 1 intramuscularly in the specified order: Td 0.5 mL PPSV23 0.5 mL MCV4 0.5 mL
Tecfidera Treated Plus VaccinationsEXPERIMENTALParticipants on a stable approved dose of Tecfidera (240 mg BID) for ≥6 months will receive 3 vaccinations on Day 1 intramuscularly in the specified order: Td 0.5 mL PPSV23 0.5 mL MCV4 0.5 mL
Glatiramer acetate (GA) and dimethyl fumarateEXPERIMENTALParticipants taking a stable dose of GA for at least 12 months prior to the study remain on that dose throughout the study. Dimethyl fumarate is administered at 120 mg three times a day (TID) on Days 1-7, and 240 mg TID on Day 8 until the end of treatment (approximately 6 months).
Interferon beta (IFNβ) and dimethyl fumarateEXPERIMENTALParticipants taking a stable dose of one of the IFNβ products for at least 12 months prior to the study remain on that product and dose throughout the study. Dimethyl fumarate is administered at 120 mg three times a day (TID) on Days 1-7, and 240 mg TID on Day 8 until the end of treatment (approximately 6 months).
BG00012 Part 1EXPERIMENTALBG00012 120 mg delivered to varying locations of the GI tract
BG00012 Part 2EXPERIMENTALBG00012 240 mg delivered to varying locations of the GI tract
BG00012 plus ASAEXPERIMENTAL -
BG00012 plus ASA matching placeboEXPERIMENTAL -
BG00012 Placebo plus ASAPLACEBO_COMPARATOR -
BG00012 Placebo plus ASA matching placeboEXPERIMENTAL -

Interventions

NameTypeDescription
dimethyl fumarateDRUGadministered orally
Interferon β-1aDRUGadministered by intramuscular injection
PlaceboDRUGTwo placebo capsules orally BID
tetanus diphtheria toxoids vaccineBIOLOGICALAdministered as described in the treatment arm
23-valent pneumococcal polysaccharide vaccineBIOLOGICALAdministered as described in the treatment arm
meningococcal polysaccharide diphtheria conjugate vaccine (quadrivalent)BIOLOGICALAdministered as described in the treatment arm
non-pegylated interferonDRUGThroughout the study participants will remain on their existing, stable dosing regimen of non-pegylated IFN.
Dimethyl Fumarate (BG00012)DRUG -
AspirinDRUG -
BG00012 matching placeboDRUG -
ASA matching placeboDRUG -
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Eligibility Criteria

Age Range10 Years to 17 Years
SexALL
Healthy VolunteersNo
Study Sites12

Key Inclusion Criteria: * Ability of parents, legal guardians, and/or subjects to understand the purpose and risks of the study and provide signed and dated informed consent and authorization to use confidential health information in accordance with national and local subject privacy regulations. S...

Countries:United StatesBelgiumBulgariaCzechiaGermanyKuwaitLatviaLebanonPolandTurkey (Türkiye)LithuaniaCanadaDenmarkFranceHungaryIsraelItalySerbiaSpainSwedenUnited KingdomJapanSouth KoreaTaiwanAustraliaAustriaBelarusBosnia and HerzegovinaCroatiaEstoniaGreeceIndiaIrelandMexicoMoldovaNetherlandsNew ZealandNorth MacedoniaPuerto RicoRomaniaSlovakiaSouth AfricaSwitzerlandUkraine
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Recent Changes (Last 90 Days)

MEDIUMJun 19, 2026NCT02283853TRIAL_REMOVED: changed
MEDIUMJun 19, 2026NCT02283853TRIAL_REMOVED: changed
MEDIUMJun 19, 2026NCT02283853TRIAL_REMOVED: changed

Frequently asked questions about dimethyl

What is Dimethyl Fumarate used for?

Dimethyl Fumarate is used for the treatment of relapsing forms of multiple sclerosis, including relapsing-remitting multiple sclerosis (RRMS). It is also studied in healthy volunteers and in primary progressive multiple sclerosis. The drug is being developed as a small molecule therapy for these neurological conditions.

Who makes Dimethyl Fumarate?

Dimethyl Fumarate is developed by Biogen Inc., a biotechnology company traded on the NASDAQ under the ticker symbol BIIB. Biogen is conducting clinical trials to evaluate the drug's safety and efficacy in patients with multiple sclerosis, including relapsing-remitting forms of the disease.

What phase is Dimethyl Fumarate in?

Dimethyl Fumarate is in Phase 1 of clinical development, though completed trials include Phase 2 and Phase 3 studies. The drug is investigational and not yet approved by regulatory authorities. It has completed four clinical trials with a total enrollment of 2,225 participants.

What clinical trials is Dimethyl Fumarate in?

Dimethyl Fumarate has completed four clinical trials, including NCT02410200, a Phase 2 study in pediatric RRMS patients; NCT02525874, a Phase 3 study on lymphocyte subsets; NCT02555215, a Phase 3 extension study in pediatric patients; and NCT02579681, a Phase 3 cognition study in RRMS patients.

Is Dimethyl Fumarate the same as Dimethyl Fumarate?

Dimethyl Fumarate is also known as Dimethyl Fumarate. The drug is referred to by both names in clinical research and medical literature. This alternative name is used interchangeably when discussing the compound in the context of multiple sclerosis treatment trials.

Is Dimethyl Fumarate FDA approved?

Dimethyl Fumarate is not FDA approved and remains an investigational drug in clinical development. The completed trials have evaluated its use in multiple sclerosis, but regulatory approval has not been granted. The drug is still undergoing study to determine its safety and effectiveness.