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Tolebrutinib

Phase 3

Relapsing Multiple Sclerosis | Small molecule | Immunology |Sanofi|Last Updated: Feb 13, 2026

Success Probability
Approval Probability 71%
TA Base Rate26%
Adjusted LOA41%
ML RiskLOW_RISK
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Market & Valuation
rNPV $3.2B
Market Size $9.4B
Revenue Basis $1.6B
Competitors 6
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Trial Design
RandomizedDouble-BlindACTIVE_CONTROLLEDDMCBiomarker
Total Trials4
Total Enrollment4,498
FDA Designations
No designations recorded
Clinical Trials (4)
NCT IDTitlePhaseStatusEnrollmentVelocityDesignStartCompletionLast UpdatedSitesCountries
NCT06372145A Study to Investigate Long-term Safety and Tolerability of Tolebrutinib in Participants With Multiple Sclerosis.PHASE3 ACTIVE NOT_RECRUITING 2,500Apr 16, 2024Apr 30, 2029Feb 13, 2026352 United States, Argentina +45
NCT04410978Relapsing Forms of Multiple Sclerosis (RMS) Study of Bruton's Tyrosine Kinase (BTK) Inhibitor Tolebrutinib (SAR442168) (GEMINI 1)PHASE3 COMPLETED 974Jun 30, 2020Jul 15, 2024Jul 2, 2025179 United States, Austria +22
NCT04410991Relapsing Forms of Multiple Sclerosis (RMS) Study of Bruton's Tyrosine Kinase (BTK) Inhibitor Tolebrutinib (SAR442168) (GEMINI 2)PHASE3 COMPLETED 899Jun 11, 2020Jul 16, 2024Jul 2, 2025186 United States, Argentina +26
NCT03996291Long Term Safety and Efficacy Study of Tolebrutinib (SAR442168) in Participants With Relapsing Multiple SclerosisPHASE2 COMPLETED 125Sep 23, 2019Nov 26, 2024Oct 23, 202537 United States, Canada +7
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Study Endpoints
Primary Endpoints
Number of Participants with Adverse Events (AEs) and Serious Adverse Events (SAEs), Adverse Events of Special Interest (AESIs) and AEs leading to permanent study intervention discontinuation
From baseline until the End of study approximately 3 years per participant
Number of Participants with Potentially clinically significant abnormalities (PCSAs)
From baseline until the End of study approximately 3 years per participant

Potentially clinically significant abnormalities (PCSAs) determined by laboratory tests, electrocardiogram (ECG), or vital signs and safety findings on MRI during the study period.

Annualized Relapse Rate (ARR) as Assessed by Confirmed Protocol-defined Adjudicated Relapses
Baseline (Day 1) to approximately 48 months

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.

Number of Participants With Treatment-emergent Adverse Events (TEAEs) and Treatment-emergent Serious Adverse Events (TESAEs)
From first dose of study drug (Day 1) up to maximum exposure, 39 weeks in Part A and 222 weeks in Part B

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.

Secondary Endpoints
Time to onset of 6-month confirmed disability worsening (CDW for RMS) or confirmed disability progression (CDP for PPMS and NRSPMS) for participants from pivotal studies
From baseline until the End of study approximately 3 years per participant
Annualized Relapse Rate (ARR) for RMS only
From baseline until the End of study approximately 3 years per participant
Number of new and/or enlarging T2-hyperintense lesions per year
From baseline until the End of study approximately 3 years per participant
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Study Design & Arms
AllocationNON_RANDOMIZED
MaskingNONE
ModelSINGLE_GROUP
PurposeTREATMENT
Treatment Arms
ArmTypeDescription
TolebrutinibEXPERIMENTAL* 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.
TeriflunomideACTIVE_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.
SAR442168EXPERIMENTAL60 mg oral SAR442168 + placebo to match the teriflunomide tablet once daily
Interventions
NameTypeDescription
TolebrutinibDRUGPharmaceutical form:Tablet-Route of administration:oral
PlaceboDRUGPharmaceutical form:Tablet-Route of administration:oral
TeriflunomideDRUGPharmaceutical form:Tablet-Route of administration:oral
Placebo to match TolebrutinibDRUGPharmaceutical form: Tablet Route of administration: Oral
Placebo to match TeriflunomideDRUGPharmaceutical form: Tablet Route of administration: Oral
Teriflunomide HMR1726DRUGPharmaceutical form: Tablet Route of administration: Oral
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Eligibility Criteria
Age Range18 Years — N/A
SexALL
Healthy VolunteersNo
Study Sites352

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...

Countries:United StatesArgentinaAustraliaAustriaBelgiumBrazilBulgariaCanadaChileChinaColombiaCroatiaCzechiaDenmarkEstoniaFinlandFranceGeorgiaGermanyGreeceHong KongHungaryIndiaIsraelItalyJapanLatviaLithuaniaMexicoNetherlandsNorwayPolandPortugalPuerto RicoRomaniaSerbiaSlovakiaSouth AfricaSouth KoreaSpainSwedenSwitzerlandTaiwanThailandTurkey (Türkiye)UkraineUnited KingdomBelarusRussia
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Recent Changes (Last 90 Days)
LOWMay 26, 2026NCT06372145primaryCompletionDate: changed
LOWMay 24, 2026NCT06372145studyFirstPostDate: changed