Approval Probability
TA Base Rate
Adjusted LOA
ML Risk
Laquinimod · 9 trials · 8 indications
Time to CDP was defined as the time to a sustained increase in Kurtzke's Expanded Disability Status Scale (EDSS) score of at least 1 point if baseline EDSS score was less than or equal to 5.0, or at least 0.5 point if the baseline EDSS score was 5.5, over a period of at least three months. EDSS assesses disability in 8 functional systems with an overall score ranging from 0 (normal) to 10 (death due to multiple sclerosis \[MS\]). Data is presented as distribution of CDP (number of participants with CDP) sustained for 3 months.
A relapse was defined as the appearance of new neurological abnormalities or the reappearance of previously observed neurological abnormalities; lasting at least 48 hours and immediately preceded by an improved neurological state of ≥30 days from onset of previous relapse, accompanied by observed objective neurological changes (an increase of ≥0.5 in Expanded Disability Status Scale \[EDSS\] score, or an increase of 1 grade in the score of 2 or more of the 7 Functional Systems \[FS\], or an increase of 2 grades in the score of 1 FS as compared to the previous evaluation). Total number of confirmed relapses during the treatment period was divided by the sum of number of days on study in the treatment period and then multiplied by the number of days in the year to calculate the annualized relapse rate. Annualized relapse rate was derived from a baseline-adjusted negative binomial regression.
A relapse was defined as the appearance of at least one new neurological abnormality or the reappearance of at least one previously observed neurological abnormalities lasting greater than or equal to 48 hours and immediately preceded by an improving neurological state of greater than or equal to 30 days from onset of previous relapse. An event was counted as a relapse only when the participant's symptoms were accompanied by observed objective neurological changes, consistent with one or more of the following: An increase of greater than or equal to 0.5 in the Expanded Disability Status Scale (EDSS) score as compared to previous evaluation, an increase of one grade in the actual score of greater than or equal to 2 of the 7 functional systems (FS), as compared to previous evaluation, or an increase of 2 grades in the actual score of one FS as compared to the previous evaluation.
Brain atrophy (BA) was measured using magnetic resonance imaging (MRI) scans of the brain. BA was analyzed using baseline-adjusted repeated measures analysis of covariance (ANCOVA- SAS® PROC MIXED) in which 1 contrast was constructed in order to compare between laquinimod 0.6 mg and placebo. The statistical model was a repeated measures analysis of covariance with treatment group, week, treatment group by week interaction, normalized brain volume at baseline, natural logarithm of T2 lesion volume at baseline, and country as fixed effects. Only on-treatment observations (include all the assessments done up to one month after the last dose of the study drug) were included. Values are adjusted means. The cancelled laquinimod 1.5 mg treatment arm was not included in the repeated measures ANCOVA model analysis. However PBVC by visit data are offered in outcome #2.
Brain atrophy (BA) was measured using magnetic resonance imaging (MRI) scans of the brain. Early termination scans of participants who discontinued the study after week 36 are considered scans at week 48.
UHDRS is a research tool developed by Huntington Disease (HD) Study Group to provide a uniform assessment of the clinical features and course of HD. Components of the full UHDRS assess motor function, cognition, behaviour, functional abilities, independence scale and total functional capacities. Motor function assessment includes TMS and Total Functional Capacity (TFC) score. The UHDRS TMS assesses all the motor features of HD and includes maximal chorea, maximal dystonia, ocular pursuit, saccade initiation and velocity, dysarthria, tongue protrusion, finger tapping, hand pronation and supination, luria, rigidity, bradykinesia, gait, tandem walking, and retropulsion pull test. Each of these was rated on a scale of 0 (normal motor function) to 4 (severely impaired motor function). TMS score is a sum of individual scores ranging from 0 (normal motor function) to 124 (severely impaired motor function). Lower TMS scores indicate better motor function.
An AE was any untoward medical occurrence in a participant who received study drug without regard to possibility of causal relationship. Serious adverse event (SAE) was an AE resulting in any of the following outcomes or deemed significant for any other reason: death; initial or prolonged inpatient hospitalization; life-threatening experience (immediate risk of dying); persistent or significant disability/incapacity; congenital anomaly. AEs included both SAEs and non-serious AEs. A summary of other non-serious AEs and all SAEs, regardless of causality is located in the 'Reported AE section'.
The number of swollen joints was used to assess lupus arthritis activity. Joint swelling was defined as soft tissue swelling that was detectable along the joint margins. 66 joints were examined for swelling. These joints include the temporomandibular (n = 2), sternoclavicular (n =2), acromioclavicular (n = 2), shoulder (n = 2), elbow (n = 2), wrist (n = 2), metacarpophalageal (n= 10), interphalangeal of thumb (n = 2), distal interphalangeal (n = 8), proximal interphalangeal (n =8), knee (n = 2), ankle mortise (n = 2), ankle tarsus (n = 2), metatarsophalangeal (n = 10), interphalangeal of great toe (n = 2), and proximal/distal interphalangeal of the toes (n = 8).
The number of tender joints was used to assess lupus arthritis activity. Joint tenderness was defined as the presence or absence of tenderness and/or pain in a joint at rest with pressure or on passive movement of the joint and joint manipulation. 68 joints were examined for tenderness. These joints include the temporomandibular (n = 2), sternoclavicular (n =2), acromioclavicular (n = 2), shoulder (n = 2), elbow (n = 2), wrist (n = 2), metacarpophalageal (n= 10), interphalangeal of thumb (n = 2), distal interphalangeal (n = 8), proximal interphalangeal (n =8), hip (n = 2), knee (n = 2), ankle mortise (n = 2), ankle tarsus (n = 2), metatarsophalangeal (n = 10), interphalangeal of great toe (n = 2), and proximal/distal interphalangeal of the toes (n = 8).
Estimated Glomerular Filtration Rate (eGFR) was calculated using the Modification of Diet in Renal Disease (MDRD) formula.
to assess the effect of once daily oral doses of laquinimod on the pharmacokinetics (PK) of ethinylestradiol (EE) and levonorgestrel (LNG)
to assess the effect of once daily oral doses of laquinimod on the pharmacokinetics (PK) of ethinylestradiol (EE) and levonorgestrel (LNG
| Arm | Type | Description |
|---|---|---|
| Placebo-Controlled Phase: Placebo | PLACEBO_COMPARATOR | Participants will receive 2 capsules of placebo (matching to laquinimod 0.6 milligrams \[mg\]) once daily orally for up to 24 months. |
| Placebo-Controlled Phase: Laquinimod 0.6 mg | EXPERIMENTAL | Participants will receive 1 capsule of laquinimod 0.6 mg and 1 capsule of matching placebo once daily orally for up to 24 months. |
| Placebo-Controlled Phase: Laquinimod 1.2 mg | EXPERIMENTAL | Participants will receive laquinimod 1.2 mg (2 capsules of laquinimod 0.6 mg each) once daily orally for up to 24 months. |
| Active Treatment Phase: Laquinimod 0.6 mg | EXPERIMENTAL | Participants who completed the placebo-controlled phase on placebo and on laquinimod 0.6 mg treatment group after 01 January 2016, will receive 1 capsule of laquinimod 0.6 mg and 1 capsule of matching placebo once daily orally for 24 months. |
| Active Treatment Phase: Laquinimod 1.2 mg | EXPERIMENTAL | Participants who completed the placebo-controlled phase on placebo and on laquinimod 1.2 mg treatment group prior to 01 January 2016, will receive laquinimod 1.2 mg (2 capsules of laquinimod 0.6 mg each) once daily orally for 24 months. |
| Active Treatment Phase: Off Drug | NO_INTERVENTION | Participants who were discontinued from treatment with laquinimod 1.2 mg during the placebo-controlled phase due to sponsor decision after 01 January 2016 will continue the active-treatment phase off drug for 24 months. |
| Placebo | PLACEBO_COMPARATOR | Participants will receive 1 capsule of placebo matching to laquinimod orally once daily for 24 months. |
| Laquinimod | EXPERIMENTAL | Participants will receive 1 capsule of laquinimod 0.6 mg orally once daily for 24 months. |
| Avonex® | ACTIVE_COMPARATOR | Participants will receive an injection of Avonex® 30 micrograms (mcg) given intramuscularly (IM) once weekly for 24 months. |
| Laquinimod 0.6 mg | EXPERIMENTAL | 1 capsule containing 0.6 mg laquinimod and 2 capsules containing placebo were administered orally once daily for at least 48 weeks. |
| Laquinimod 1.5 mg | EXPERIMENTAL | 3 capsules containing 0.5 mg laquinimod were administered orally once daily for at least 48 weeks. However this arm was discontinued as of 01 January 2016 and no participants reached the 48 week timeframe. |
| Laquinimod 0.5 mg | EXPERIMENTAL | Participants will receive 1 capsule of laquinimod 0.5 milligrams (mg) and 2 capsules of matching placebo, orally once daily for 52 weeks. |
| Laquinimod 1.0 mg | EXPERIMENTAL | Participants will receive 2 capsule of laquinimod 0.5 mg (total 1.0 mg laquinimod) and 1 capsule of matching placebo, orally once daily for 52 weeks. |
| Laquinimod 1 mg | EXPERIMENTAL | Participants will receive 2 capsules of laquinimod 0.5 mg orally once daily for 12 weeks. |
| Name | Type | Description |
|---|---|---|
| Laquinimod | DRUG | Laquinimod will be administered as per the dose and schedule specified in the respective arms. |
| Placebo | DRUG | Placebo matching to laquinimod will be administered as per the schedule specified in the respective arms. |
| Avonex® | DRUG | Avonex® will be administered per dose and schedule specified in the arm description. |
| Mycophenolate Mofetil | DRUG | Mycophenolate Mofetil (MMF) will be administered per dose and schedule specified in the arm description. |
| Prednisolone/Prednisone | DRUG | Prednisolone/Prednisone will be administered per dose and schedule specified in the arm description. |
| Methylprednisolone | DRUG | Methylprednisolone (MP) will be administered per dose and schedule specified in the arm description. |
Inclusion Criteria: * Participants must have a confirmed and documented multiple sclerosis (MS) diagnosis as defined by the Revised McDonald criteria, with relapse onset disease or a relapsing-remitting disease course. * Participants must be ambulatory with Kurtzke's expanded disability status scal...
Laquinimod is an investigational small molecule being studied for relapsing remitting multiple sclerosis, lupus nephritis, and other conditions including lupus arthritis, Crohn's disease, Huntington's disease, and primary progressive multiple sclerosis. It has been evaluated in placebo-controlled clinical trials for these indications.
Laquinimod is being developed by Teva Pharmaceutical Industries Limited, a company traded on the New York Stock Exchange under the ticker TEVA. Teva has sponsored multiple clinical trials of the drug in multiple sclerosis and lupus nephritis.
Laquinimod has completed Phase 2 and Phase 3 clinical trials. It remains an investigational drug and is not approved for any indication. The most advanced completed trials were Phase 3 studies in relapsing remitting multiple sclerosis.
Laquinimod has been studied in several completed trials, including NCT00509145 and NCT01707992 in relapsing remitting multiple sclerosis, NCT00605215 (the BRAVO study) comparing it to placebo with a reference arm of interferon beta-1a, and NCT01085097 in lupus nephritis. These trials were randomized, double-blind, and placebo-controlled.
Laquinimod is a small molecule immunomodulator. It is thought to modulate the immune system, but its exact mechanism of action is not fully established. It has been investigated for its effects on inflammatory processes in multiple sclerosis and lupus nephritis.
Laquinimod is a distinct investigational compound and is not known to be the same as any other marketed drug. It has been studied under the name laquinimod in clinical trials sponsored by Teva Pharmaceutical Industries.