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Orelabrutinib

Phase 3

Multiple Sclerosis (MS) Primary Progressive | Small molecule | Neurology |Zenas BioPharma, Inc.|Trials Updated: Oct 21, 2026

Orelabrutinib development status

Highest phase Phase 3
Registered trials 2 across 1 sponsor since Jul 2025

Orelabrutinib target and mechanism

Molecular targetBTK
Target classInhibitor
ModalitySmall molecule

Success Probability

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Market & Valuation

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Trial Design

RandomizedDouble-BlindPLACEBO_CONTROLLED
Total Trials2
Total Enrollment1,695

FDA Designations

No designations recorded

Orelabrutinib clinical trials

Orelabrutinib · 2 trials · 2 indications

Phase 3 2
NCT07067463A Study of Orelabrutinib in Patients With Primary Progressive Multiple SclerosisMultiple Sclerosis (MS) Primary Progressive
RECRUITING705 Analytics
NCT07299019A Study of Orelabrutinib in Patients With Secondary Progressive Multiple SclerosisSecondary Progressive Multiple Sclerosis
RECRUITING990 Analytics
PHASE3RECRUITING
A Study of Orelabrutinib in Patients With Primary Progressive Multiple Sclerosis
Multiple Sclerosis (MS) Primary ProgressiveUnlock trial analytics
PHASE3RECRUITING
A Study of Orelabrutinib in Patients With Secondary Progressive Multiple Sclerosis
Secondary Progressive Multiple SclerosisUnlock trial analytics

Study Endpoints

Primary Endpoints

Time to onset of composite confirmed disability progression (cCDP) , confirmed over at least 12 weeks (12-week cCDP)
Up to approximately 120 weeks

* Expanded disability status scale (EDSS) score increase ≥ 1.0 point from baseline when the baseline score is ≤ 5.0, or ≥ 0.5 points from baseline when the baseline score is \> 5.0, OR * ≥ 20% increase in the Timed 25-Foot Walk Test (T25FWT), OR * ≥ 20% increase in the 9-hole Peg Test (9HPT)

Time to onset of confirmed disability progression (CDP) events, confirmed over at least 24 weeks
Up to approximately 120 weeks

Expanded disability status scale (EDSS) score increase ≥ 1.0 point from baseline when the baseline score is ≤ 5.0, or ≥ 0.5 points from baseline when the baseline score is \> 5.0

Secondary Endpoints

Time to onset of composite confirmed disability progression (cCDP) , confirmed over at least 24 weeks (24-week cCDP)
Up to approximately 120 weeks
Time to onset of confirmed disability progression (CDP) , confirmed over at least 24 weeks (24-week CDP)
Up to approximately 120 weeks
MRI T2 lesion
Up to approximately 120 weeks
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Study Design & Arms

AllocationRANDOMIZED
MaskingQUADRUPLE
ModelPARALLEL
PurposeTREATMENT

Treatment Arms

ArmTypeDescription
Orelabrutinib GroupEXPERIMENTAL -
Placebo GroupPLACEBO_COMPARATOR -

Interventions

NameTypeDescription
OrelabrutinibDRUGOrally
PlaceboDRUGOrally
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Eligibility Criteria

Age Range18 Years to 60 Years
SexALL
Healthy VolunteersNo
Study Sites71

Inclusion Criteria: * 18 to 60 years of age, inclusive * Diagnosed with Primary Progressive MS (PPMS) according to 2017 McDonald criteria * Participant must have documented evidence of disability progression observed during the 24 months before screening. * Expanded disability status scale (EDSS) s...

Countries:United StatesBulgariaCroatiaCzechiaEstoniaGeorgiaGermanyItalyNetherlandsPolandPuerto RicoRomaniaSerbiaSlovakiaSpainUkraineHungaryLithuania
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Recent Changes (Last 90 Days)

LOWOct 21, 2026NCT07299019lastUpdatePostDate: changed
LOWOct 21, 2026NCT07299019lastUpdatePostDate: changed
LOWOct 21, 2026NCT07299019lastUpdatePostDate: changed
LOWOct 20, 2026NCT07067463lastUpdatePostDate: changed
LOWOct 20, 2026NCT07067463lastUpdatePostDate: changed
LOWOct 13, 2026NCT07067463lastUpdatePostDate: changed
LOWOct 13, 2026NCT07067463lastUpdatePostDate: changed
LOWOct 7, 2026NCT07299019lastUpdatePostDate: changed
LOWOct 7, 2026NCT07299019lastUpdatePostDate: changed
LOWOct 5, 2026NCT07067463lastUpdatePostDate: changed
LOWOct 5, 2026NCT07067463lastUpdatePostDate: changed
LOWSep 30, 2026NCT07299019lastUpdatePostDate: changed
LOWSep 30, 2026NCT07299019lastUpdatePostDate: changed
LOWSep 23, 2026NCT07299019lastUpdatePostDate: changed
LOWSep 23, 2026NCT07299019lastUpdatePostDate: changed
LOWSep 22, 2026NCT07067463lastUpdatePostDate: changed
LOWSep 22, 2026NCT07067463lastUpdatePostDate: changed
LOWSep 16, 2026NCT07299019lastUpdatePostDate: changed
LOWSep 16, 2026NCT07067463lastUpdatePostDate: changed
LOWSep 16, 2026NCT07299019lastUpdatePostDate: changed

Frequently asked questions about Orelabrutinib

What is Orelabrutinib?

Orelabrutinib is an investigational small molecule BTK inhibitor being developed by Zenas BioPharma, Inc. (ticker ZBIO) for neurological indications. It is in Phase 3 clinical development for primary progressive and secondary progressive multiple sclerosis, a neurology therapeutic area. It is a placebo-controlled, randomized, double-blind study program in adults 18 years and older.

What is Orelabrutinib used for in multiple sclerosis?

Orelabrutinib is being studied for primary progressive multiple sclerosis and secondary progressive multiple sclerosis. Both are progressive forms of MS, and the Phase 3 program enrolls adults 18 years and older. The trials are randomized, double-blind, and placebo-controlled, and neither study includes healthy volunteers.

What does Orelabrutinib target?

Orelabrutinib targets BTK, Bruton's tyrosine kinase, and acts as a BTK inhibitor. BTK inhibition is the mechanism under study in its multiple sclerosis program. It is a small molecule administered as an oral agent in clinical development for progressive forms of MS.

Who is developing Orelabrutinib?

Zenas BioPharma, Inc., which trades under the ticker ZBIO, is developing orelabrutinib. The company is running the Phase 3 program in primary progressive and secondary progressive multiple sclerosis across sites in the United States, Europe, and other countries.

What phase is Orelabrutinib in?

Orelabrutinib is in Phase 3 clinical development for progressive multiple sclerosis. It is investigational and is not described as approved for any indication. The Phase 3 studies are randomized, double-blind, and placebo-controlled, with enrollment targets of 990 and 705 participants respectively.

What clinical trials is Orelabrutinib in?

Orelabrutinib is being studied in two recruiting Phase 3 trials: NCT07299019 in secondary progressive multiple sclerosis, targeting 990 participants, and NCT07067463 in primary progressive multiple sclerosis, targeting 705 participants. Both enroll adults 18 years and older of all sexes and are conducted across multiple countries including the United States and sites in Europe.