Approval Probability
TA Base Rate
Adjusted LOA
ML Risk
Also known as SAR442168
Tolebrutinib · 12 trials · 8 indications
Potentially clinically significant abnormalities (PCSAs) determined by laboratory tests, electrocardiogram (ECG), or vital signs and safety findings on MRI during the study period.
The EDSS is a disability scale that assesses the following 7 functional domains: visual, brainstem, pyramidal \[motor\], cerebellar \[coordination\], sensory, cerebral, and bowel/bladder. The total EDSS ranges from 0 (normal) to 10 (death due to multiple sclerosis \[MS\]) (0.5 increments from 1-10; next increase after 0 is 1). Higher scores indicated increased disability. Time to onset of 6-month CDP was defined as the time from randomization to the onset of a sustained increase from baseline in EDSS score of \>=1.0 point from the baseline EDSS score when the baseline score was \<=5.0 or of \>=0.5 points when the baseline EDSS score was \>5.0 confirmed after a minimum 6-month interval.
Time to onset of 6-month cCDP defined as follows: Increase over at least 6 months of ≥1.0 point from the baseline expanded disability status scale (EDSS) score when the baseline score is ≤5.5, or ≥0.5 points when the baseline EDSS score is \>5.5, or ≥20% from the baseline T25-FW, or ≥20% from the baseline 9-HPT
Multiple sclerosis (MS) relapse was defined as a monophasic, acute or subacute onset of new neurological symptoms or worsening of previous neurological symptoms with an objective change on neurological examination. Symptoms were attributable to MS, lasted for \>=24 hours with or without recovery, present at normal body temperature, and preceded by \>=30 days of clinical stability.
An AE was any untoward medical occurrence in a participant or clinical study participant, temporally associated with the use of study drug, whether or not considered related to the study drug. An SAE was any untoward medical occurrence that at any dose: resulted in death, was life-threatening, required inpatient hospitalization or prolongation of existing hospitalization, resulted in persistent disability/incapacity, was a congenital anomaly/birth defect or was an important medical event. TEAEs were defined as AEs that developed, worsened or became serious during the respective on-treatment periods.
Number of new Gd-enhancing T1-hyperintense lesions was detected by brain MRI at the end of 12 weeks of SAR442168 treatment (i.e., at Week 12 for Cohort 1 participants and Week 16 for Cohort 2 participants). Data was planned to be collected and analyzed on pooled population of participants at each dose level of SAR442168 (either in Cohort 1 and 2) and pooled population of participants receiving placebo in Cohort 2 and was not planned to collected during placebo administration in Cohort 1 (Weeks 12 to 16).
Area under the plasma concentration (AUC) versus time curve extrapolated to infinity
AUC up to the last measurable concentration
Area under the curve, reflects the concentration of drug
Fractional and cumulative percentage of radioactive dose excreted in urine and feces of \[14C\]-SAR442168
| Arm | Type | Description |
|---|---|---|
| Tolebrutinib | EXPERIMENTAL | * Participants will receive OL tolebrunitib 60 mg once daily. * RMS participants who are not eligible for OL tolebrutinib per Health Authority and/or ethics committee decisions on the study conduct (ie, partial hold on initiation of tolebrutinib) will continue their parent study treatment assignment as per their randomization from the parent study. |
| Teriflunomide | ACTIVE_COMPARATOR | * participants will receive teriflunomide 14 mg daily * RMS participants who are not eligible for OL tolebrutinib per Health Authority and/or ethics committee decisions on the study conduct (ie, partial hold on initiation of tolebrutinib) will continue their parent study treatment assignment (either tolebrutinib or teriflunomide) as per their randomization from the parent study. If unblinded to teriflunomide parent study treatment assignment, these RMS participants will continue teriflunomide in the LTS17043 study. |
| SAR442168 | EXPERIMENTAL | 60 mg of oral SAR442168 once daily |
| Placebo | PLACEBO_COMPARATOR | Placebo tablet to match SAR442168 once daily |
| Cohort 1: SAR442168 5 mg Then Placebo | EXPERIMENTAL | Participants received SAR442168 5 milligrams (mg), orally once daily for first 12 weeks then crossed over to matching placebo orally once daily for 4 weeks during the 16 weeks treatment period. To maintain the blinding, each participant was given a total of 4 tablets daily, either of SAR442168 or SAR442168 and placebo, to achieve the specified daily dose of SAR442168. |
| Cohort 1: SAR442168 15 mg Then Placebo | EXPERIMENTAL | Participants received SAR442168 15 mg, orally once daily for first 12 weeks then crossed over to matching placebo orally once daily for 4 weeks during the 16 weeks treatment period. To maintain the blinding, each participant was given a total of 4 tablets daily, either of SAR442168 or SAR442168 and placebo, to achieve the specified daily dose of SAR442168. |
| Cohort 1: SAR442168 30 mg Then Placebo | EXPERIMENTAL | Participants received SAR442168 30 mg, orally once daily for first 12 weeks then crossed over to matching placebo orally once daily for 4 weeks during the 16 weeks treatment period. To maintain the blinding, each participant was given a total of 4 tablets daily, either of SAR442168 or SAR442168 and placebo, to achieve the specified daily dose of SAR442168. |
| Cohort 1: SAR442168 60 mg Then Placebo | EXPERIMENTAL | Participants received SAR442168 60 mg, orally once daily for first 12 weeks then crossed over to matching placebo orally once daily for 4 weeks during the 16 weeks treatment period. To maintain the blinding, each participant was given a total of 4 tablets daily, either of SAR442168 or SAR442168 and placebo, to achieve the specified daily dose of SAR442168. |
| Cohort 2: Placebo Then SAR442168 5 mg | EXPERIMENTAL | Participants received placebo matching to SAR442168 tablets, orally once daily for first 4 weeks then crossed over to SAR442168 5 mg orally once daily for 12 weeks during the 16 weeks treatment period. To maintain the blinding, each participant was given a total of 4 tablets daily, either of SAR442168 or SAR442168 and placebo, to achieve the specified daily dose of SAR442168. |
| Cohort 2: Placebo Then SAR442168 15 mg | EXPERIMENTAL | Participants received placebo matching to SAR442168 tablets, orally once daily for first 4 weeks then crossed over to SAR442168 15 mg orally once daily for 12 weeks during the 16 weeks treatment period. To maintain the blinding, each participant was given a total of 4 tablets daily, either of SAR442168 or SAR442168 and placebo, to achieve the specified daily dose of SAR442168. |
| Cohort 2: Placebo Then SAR442168 30 mg | EXPERIMENTAL | Participants received placebo matching to SAR442168 tablets, orally once daily for first 4 weeks then crossed over to SAR442168 30 mg orally once daily for 12 weeks during the 16 weeks treatment period. To maintain the blinding, each participant was given a total of 4 tablets daily, either of SAR442168 or SAR442168 and placebo, to achieve the specified daily dose of SAR442168. |
| Cohort 2: Placebo Then SAR442168 60 mg | EXPERIMENTAL | Participants received placebo matching to SAR442168 tablets, orally once daily for first 4 weeks then crossed over to SAR442168 60 mg orally once daily for 12 weeks during the 16 weeks treatment period. To maintain the blinding, each participant was given a total of 4 tablets daily, either of SAR442168 or SAR442168 and placebo, to achieve the specified daily dose of SAR442168. |
| Mild hepatic impairment group | EXPERIMENTAL | Single dose of tolebrutinib (SAR442168) will be administered on Day 1 under fed condition |
| Normal hepatic function group | EXPERIMENTAL | Single dose of tolebrutinib (SAR442168) will be administered on Day 1 under fed condition |
| Severe Renal Impairment (RI) group (Part A only) | EXPERIMENTAL | Single dose of tolebrutinib (SAR442168) will be administered on Day 1 under fed condition |
| Normal Renal Function group (Part A and B) | EXPERIMENTAL | Single dose of tolebrutinib (SAR442168) will be administered on Day 1 under fed condition |
| Moderate RI group (Part B only conditional) | EXPERIMENTAL | Single dose of tolebrutinib (SAR442168) will be administered on Day 1 under fed condition |
| Part 1a | EXPERIMENTAL | 3 single ascending doses of SAR442168 or placebo in fasted and fed (high-fat breakfast) conditions |
| Part 1b | EXPERIMENTAL | 2 single doses of SAR442168 under fed conditions (moderate-fat breakfast). |
| Part 1c | EXPERIMENTAL | 1 single dose of SAR442168 under fasting and fed conditions (high-fat breakfast). |
| Part 1d | EXPERIMENTAL | 1 single dose of SAR442168 under fasting and fed conditions (Standardized high-fat breakfast). |
| Part 2 | EXPERIMENTAL | 3 ascending once-daily repeated single doses of SAR442168 or placebo for 14 days under fed conditions (moderate-fat breakfast) |
| Cohort 1 | EXPERIMENTAL | SAR442168 administered alone and together with gemfibrozil. 1 day washout for each administration of SAR442168. |
| Cohort 2 | EXPERIMENTAL | SAR442168 administered alone and together with rifampicin. 1 day washout for each administration of SAR442168. |
| Name | Type | Description |
|---|---|---|
| Tolebrutinib | DRUG | Pharmaceutical form:Tablet-Route of administration:oral |
| Placebo | DRUG | Pharmaceutical form:Tablet-Route of administration:oral |
| Teriflunomide | DRUG | Pharmaceutical form:Tablet-Route of administration:oral |
| Placebo to match Tolebrutinib | DRUG | Pharmaceutical form: Film-coated tablet Route of administration: Oral |
| Placebo to match Teriflunomide | DRUG | Pharmaceutical form: Tablet Route of administration: Oral |
| Teriflunomide HMR1726 | DRUG | Pharmaceutical form: Tablet Route of administration: Oral |
| SAR442168 | DRUG | Pharmaceutical form: Film coated tablet; Route of administration: Oral |
| Locally approved intravenous contrast medium for contrast enhanced magnetic resonance imaging (MRI) | DRUG | Pharmaceutical form: Solution for injection; Route of administration: Intravenous |
| gemfibrozil | DRUG | Tablet, taken orally |
| rifampicin | DRUG | Tablet, taken orally |
Inclusion Criteria: \- Participants with RMS, PPMS, or NRSPMS who completed the Phase 2b LTS (LTS16004) or 1 of the 4 Phase 3 pivotal tolebrutinib trials (EFC16033, EFC16034, EFC16645, EFC16035) on IMP. OR \- The Phase 2b LTS (LTS16004) or Phase 3 tolebrutinib pivotal trial participants who tempo...
Tolebrutinib is an investigational oral medicine being studied for multiple sclerosis, including relapsing multiple sclerosis, primary progressive multiple sclerosis, and non-relapsing secondary progressive multiple sclerosis. It is also being evaluated in hepatic impairment and renal impairment studies. It is not approved for any use and remains in clinical development.
Tolebrutinib targets Bruton's tyrosine kinase, or BTK, and acts as a BTK inhibitor. BTK is an enzyme involved in the activation of B cells and myeloid cells thought to contribute to neuroinflammation in multiple sclerosis. By inhibiting BTK, tolebrutinib is designed to modulate this inflammatory signaling.
Tolebrutinib is being developed by Sanofi, which trades under the ticker SNY. Sanofi is the sponsor of the clinical program studying the drug across multiple sclerosis subtypes and in participants with impaired hepatic or renal function.
Tolebrutinib is in clinical development and is investigational. Its program includes Phase 1 studies in healthy volunteers and participants with hepatic impairment, along with a Phase 3 long-term safety and tolerability study in multiple sclerosis. It has not been approved by the FDA for any indication.
Tolebrutinib has been studied in four registered trials. These include the Phase 3 long-term safety study NCT06372145, the Phase 1 food effect and pharmacokinetics study NCT06106074, the Phase 1 drug-drug interaction study NCT06064539, and the Phase 1 hepatic impairment study NCT05283915. Total enrollment across these trials is about 4,498 participants.
Yes, tolebrutinib is also known as SAR442168. Both names refer to the same Sanofi BTK inhibitor. The Phase 1 tolerability and drug-drug interaction studies NCT06106074 and NCT06064539 use the SAR442168 designation, while the Phase 3 long-term safety study NCT06372145 uses the tolebrutinib name.