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IMU-838

Phase 3

Multiple Sclerosis | Small molecule | Neurology |Immunic, Inc.|Last Updated: Feb 23, 2026

Target and mechanism

Molecular targetNurr1
Target classNuclear Receptor
ModalitySmall molecule

Also known as IMU-838 tablets

Success Probability

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Market & Valuation

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Trial Design

RandomizedDouble-BlindPLACEBO_CONTROLLED
Total Trials1
Total Enrollment1,121

FDA Designations

No designations recorded

Clinical trial landscape

IMU-838 · 4 trials · 4 indications

Phase 3 2Phase 2 2
NCT05201638Study to Evaluate the Efficacy, Safety and Tolerability of IMU-838 in Patients With Relapsing Multiple SclerosisMultiple Sclerosis, Relapsing-Remitting
ACTIVE NOT_RECRUITING1,100 Analytics
NCT05134441Study to Evaluate the Efficacy, Safety, and Tolerability of IMU-838 in Patients With Relapsing Multiple SclerosisMultiple Sclerosis
ACTIVE NOT_RECRUITING1,121 Analytics
PHASE3ACTIVE NOT_RECRUITING
Study to Evaluate the Efficacy, Safety and Tolerability of IMU-838 in Patients With Relapsing Multiple Sclerosis
Multiple Sclerosis, Relapsing-RemittingUnlock trial analytics
PHASE3ACTIVE NOT_RECRUITING
Study to Evaluate the Efficacy, Safety, and Tolerability of IMU-838 in Patients With Relapsing Multiple Sclerosis
Multiple SclerosisUnlock trial analytics

Study Endpoints

Primary Endpoints

To evaluate efficacy of IMU-838 versus placebo based on time to first relapse
72 weeks

Survival analysis of time to first relapse, occurred after the start of study treatment administration and before the end of the double-blind period, censored at a maximum of 72 weeks.

To evaluate efficacy of IMU-838 versus placebo regarding time to first relapse
72 weeks

Survival analysis of time to first relapse, occurred after the start of study treatment administration and before the end of the double-blind period, censored at a maximum of 72 weeks.

Proportion of Patients Without Any Need for INV Until EoS
Throughout the Study (Day 0 to Day 28)

Number of Participants Stratified as those With and Without the Need for INV Until End-of-study (EoS). For this outcome a worst case approach was used in which patients who were lost to follow-up or who discontinued the trial on or before Day 13 due to any other reason than death and discontinued with a last observed WHO clinical status no lower than that at Screening, and patients who died were considered as patients requiring INV.

Difference Between 45 mg/Day IMU-838 and Placebo in the Cumulative Number of Combined Unique Active (CUA) MRI Lesions
Up to Week 24

MRI scans were assessed centrally and adhered to a standardized MRI protocol. Estimates were adjusted for baseline volume of T2 lesions, MRI field strength (1.5 or 3.0 Tesla), and baseline number of gadolinium enhancing (Gd+) lesions (0, ≥1) using a generalized linear model with a negative binomial distribution and a logarithmic link function. Log transformation of time from first IMP dose to date of last MRI assessment was used as offset term. Mainly due to the differing number of patients with 3.0 Tesla MRI examinations in each treatment arm, the statistical adjustments (to ensure comparabiltiy) for each individual comparison differed and hence the adjusted mean cumulative number of CUA MRI lesions in each arm (e.g. placebo) differed depending on the comparison (45 mg IMU-838 vs placebo, 30 mg IMU-838 vs placebo, or 45 mg vs 30 mg IMU-838).

Secondary Endpoints

Effect of IMU-838 versus placebo on volume of new T2 lesions
72 weeks
Effect of IMU-838 versus placebo on disability progression
72 weeks
Effect of IMU-838 versus placebo on cognitive performance
72 weeks
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Study Design & Arms

AllocationRANDOMIZED
MaskingQUADRUPLE
ModelPARALLEL
PurposeTREATMENT

Treatment Arms

ArmTypeDescription
IMU-838EXPERIMENTALIMU-838 (vidofludimus calcium), a small molecule inhibitor of DHODH. Formulation: Tablets with 15 or 30 mg IMU-838 for once daily oral intake in the morning.
PlaceboPLACEBO_COMPARATORMatching placebo, as described for the test product, identical number of tablets as given for IMU-838.
IMU-838 (30 mg/day)EXPERIMENTALIMU-838 tablet containing 15 mg Vidofludimus calcium (IM90838). Once-daily oral dose of 30 mg consists of 2 tablets IMU-838. Duration: until the end of the main treatment period (24 weeks). In the optional extended treatment period, patients were randomized to receive either 30 mg/day or 45 mg/day IMU-838 (up to 9.5 years for the main trial).
IMU-838 (45 mg/day)EXPERIMENTALTablet containing 22.5 mg Vidofludimus calcium (IM90838). Once-daily oral dose of 45 mg consists of 2 tablets. Duration: until the end of the main treatment period (24 weeks). In the optional extended treatment period, patients were randomized to receive either 30 mg/day or 45 mg/day IMU-838.
IMU-838 (10 mg/day) - Cohort 2EXPERIMENTALCohort 2 sub-trial: additional sub-trial with a small double-blind, placebo-controlled, randomized, parallel-group assessment of a low IMU-838 dose (i.e. 10 mg/day) to provide additional data for pharmacodynamic modelling. Tablet containing 5 mg Vidofludimus calcium (IM90838). Once-daily oral dose of 10 mg consists of 2 tablets. Duration: until the end of the main treatment period (24 weeks). In the optional extended treatment period, patients were randomized to receive either 30 mg/day or 45 mg/day IMU-838 (up to 8.5 years for the cohort 2 sub-trial).

Interventions

NameTypeDescription
IMU-838 tabletsDRUGPatients are randomized to IMU-838 or placebo in ratio 1:1
Placebo matching IMU-838 tabletsDRUGPatients are randomized to IMU-838 or placebo in ratio 1:1
IMU-838DRUGTablets will be taken BID with a glass of water (if possible); one tablet each in the morning (15 to 50 min before a meal if applicable), and in the evening (2 hours after any meal if applicable). If the patient is intubated for ventilation, IMP is to be given via a gastric tube. The tablet has no coating and a homogeneous content and can be crushed into smaller pieces (if necessary) for dosing via gastric tube.
PlaceboOTHERMatching placebo, twice-daily administration BID as described for the test product, identical number of tablets as given for IMU-838
IMU-838 (30 mg/day)DRUG* Main treatment period: All patients will receive half the assigned dose during the first 7 days of the main treatment period (one 15 mg tablet IMU-838 daily) and then start taking the full assigned dose from Day 7 onwards (two 15 mg tablets IMU-838 once daily). * Optional extended treatment period (optional): Participants who were re-randomized to a 30 mg/day dose will take the full assigned dose which consists of two 15 mg tablets IMU-838 once daily.
IMU-838 (45 mg/day)DRUG* Main treatment period: All patients will receive half the assigned dose during the first 7 days of the main treatment period (one 22.5 mg tablet per day) and then start taking the full assigned dose from Day 7 onwards (two 22.5 mg tablets once daily). * Optional extended treatment period (optional): Participants who were re-randomized to a 45 mg/day dose will take the full assigned dose of two 22.5 mg tablets IMU-838 once daily.
IMU-838 (10 mg/day)DRUG* Main treatment period for Cohort 2: All patients will receive half the assigned dose during the first 7 days of the main treatment period (one 5 mg tablet per day) and then start taking the full assigned dose from Day 7 onwards (two 5 mg tablets once daily). * Optional extended treatment period (not applicable to Cohort 2): IMU-838 10 mg/day not applicable.
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Eligibility Criteria

Age Range18 Years to 55 Years
SexALL
Healthy VolunteersNo
Study Sites76

Inclusion Criteria: * Male or female patient (age ≥18 to ≤55 years). * Patients with an established diagnosis of MS according to 2017 McDonald Criteria. * Patients with RMS comprising of relapsing remitting MS (RRMS) and active secondary progressive MS, both defined according to Lublin criteria 199...

Countries:United StatesArmeniaBosnia and HerzegovinaEstoniaGermanyIndiaPeruPolandRomaniaSerbiaTurkey (Türkiye)UkraineUnited KingdomAlbaniaAlgeriaBulgariaGeorgiaJordanLebanonLithuaniaMexicoMoldovaMontenegroNorth Macedonia
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Frequently asked questions about IMU-838

What is IMU-838 used for?

IMU-838 is an investigational small molecule being studied for relapsing-remitting multiple sclerosis (RRMS) and COVID-19. It is in Phase 2 clinical development for these indications, with Phase 3 trials also listed for multiple sclerosis. The drug is being developed by Immunic, Inc. (NASDAQ: IMUX).

What does IMU-838 target?

IMU-838 targets the nuclear receptor Nurr1. This target is involved in regulating inflammatory responses. By modulating Nurr1 activity, IMU-838 may reduce the neuroinflammation associated with relapsing-remitting multiple sclerosis. The drug is being evaluated in clinical trials for its efficacy and safety in patients with RRMS.

Who makes IMU-838?

IMU-838 is being developed by Immunic, Inc., a biopharmaceutical company traded on NASDAQ under the ticker symbol IMUX. The company is conducting clinical trials to evaluate the drug's safety and efficacy in patients with relapsing-remitting multiple sclerosis and COVID-19.

What phase is IMU-838 in?

IMU-838 is in Phase 2 clinical development for relapsing-remitting multiple sclerosis and COVID-19. The drug is investigational and not yet approved by regulatory authorities. Clinical trials are ongoing to assess its efficacy and safety in these patient populations.

What clinical trials is IMU-838 in?

IMU-838 is being studied in several clinical trials. NCT03846219 is a Phase 2 trial in relapsing-remitting multiple sclerosis. NCT04379271 is a completed Phase 2 trial in COVID-19. NCT05134441 and NCT05201638 are Phase 3 trials in relapsing multiple sclerosis. All trials are randomized, double-blind, and placebo-controlled.

Is IMU-838 the same as IMU-838 tablets?

Yes, IMU-838 is also known as IMU-838 tablets, specifically at a 30 mg/day dose. The drug is administered orally as a tablet. This formulation is being evaluated in clinical trials for the treatment of relapsing-remitting multiple sclerosis and COVID-19.