Immunic announces publication of extended data from phase 2 EMPhASIS Trial of vidofludimus calcium in relapsing-remitting multiple sclerosis in the peer-reviewed journal, Neurology Neuroimmunology & Neuroinflammation 

April 30, 2024 – Biotechnology, Drug Discovery

– 30 mg and 45 mg Daily Doses of Vidofludimus Calcium Suppressed Development of Gadolinium-Enhancing Lesions by 78% and 74% Compared to Pooled Placebo at 24 Weeks –

– Improvements in Serum Neurofilament Light Chain Consistent with Recently Announced Interim Phase 2 CALLIPER Data in Progressive Multiple Sclerosis –

– Twin Phase 3 ENSURE Trials in Relapsing Multiple Sclerosis and Phase 2 CALLIPER Trial in Progressive Multiple Sclerosis Remain Underway –

30 April 2024 – New York, US – PRNewswire – Immunic, Inc. (Nasdaq: IMUX), a biotechnology company developing a clinical pipeline of orally administered, small molecule therapies for chronic inflammatory and autoimmune diseases, today announced that data from its phase 2 EMPhASIS trial of lead asset, vidofludimus calcium (IMU-838), in patients with relapsing-remitting multiple sclerosis (RRMS) has been published online on 25 April 2024 in Neurology Neuroimmunology & Neuroinflammation, an official journal of the American Academy of Neurology.

The paper, lead authored by coordinating investigator, Robert J Fox, MD, staff neurologist, Mellen Center for Multiple Sclerosis, Vice-Chair for Research, Neurological Institute, Cleveland Clinic, Cleveland, Ohio, is entitled, “Safety and Dose-Response of Vidofludimus Calcium in Relapsing Multiple Sclerosis: Extended Results of a Placebo-Controlled Phase 2 Trial.” Dr Fox receives consulting fees for serving as an advisor to Immunic. The paper can be accessed through the following link: https://www.neurology.org/doi/full/10.1212/NXI.0000000000200208.

“The publication of our phase 2 EMPhASIS trial results for both study cohorts with an extended dose range in such a prestigious peer-reviewed journal represents further evidence of the strength of these findings for vidofludimus calcium in patients with RRMS,” stated Daniel Vitt, PhD, chief executive officer and president of Immunic. “As reported, a dose-dependent effect of vidofludimus calcium on the suppression of new combined unique active (CUA) magnetic resonance imaging (MRI) as well as gadolinium-enhancing (Gd+) lesions was demonstrated along with an encouraging initial signal towards reducing 12-week and 24-week confirmed disability worsening events as compared to placebo during the double-blind treatment period. The findings impressively underline the drug’s combined neuroprotective and anti-inflammatory effects. Meanwhile, we continue to enroll patients in our twin phase 3 ENSURE trials in relapsing multiple sclerosis, from which we expect to report an interim futility analysis in late 2024, with the top-line readout of the first of the ENSURE trials anticipated in the second quarter of 2026.”

Vidofludimus calcium, an orally available first-in-class nuclear receptor related 1 (Nurr1) activator and next-generation dihydroorotate dehydrogenase (DHODH) inhibitor, was shown to have suppressed MRI disease activity compared to placebo in patients with RRMS in the first cohort of the multicenter, double-blind, randomized, placebo-controlled phase 2 EMPhASIS trial, achieving all primary and key secondary endpoints with high statistical significance. The results of study cohort 1, exploring the doses of 30 mg and 45 mg of vidofludimus calcium in RRMS patients versus placebo, were published in Annals of Clinical and Translational Neurology in 2022 (Fox RJ, et al. Ann Clin Transl Neurol. 2022;9(7):977-987).

Given that both doses of 30 mg and 45 mg of vidofludimus calcium showed comparable robust activity on multiple endpoints, the trial enrolled an additional cohort of patients to receive a lower dose of vidofludimus calcium in order to further investigate a dose-response relationship by extending the trial to a broader dose range. Study cohort 2 explored the dose of 10 mg of vidofludimus calcium versus placebo. Extended results from the pooled EMPhASIS data (cohorts 1 and 2, including comparison to the pooled placebo group from both study cohorts) were summarized in more detail in this latest peer-reviewed article.

The pooled data showed that, compared to placebo, vidofludimus calcium suppressed the development of new CUA MRI lesions with daily doses of 30 mg and 45 mg up to week 24 by 76% and 71%, respectively. In addition, compared to placebo, vidofludimus calcium suppressed the development of Gd+ lesions with daily doses of 30 mg and 45 mg up to week 24 by 78% and 74%, respectively. Such robust anti-inflammatory effects were not seen with 10 mg, establishing 30 mg as the lowest effective dose. Serum neurofilament light chain (NfL), which is thought to correlate with neuronal destruction, decreased in a dose-dependent manner up to the highest tested dose of vidofludimus calcium by 9% (10 mg), 18% (30 mg) and 26% (45mg) compared to placebo, respectively, suggesting that the effect on NfL has a different dose-response pattern which contrasts with that observed with new CUA or Gd+ by MRI lesions.

Increases in disability over a pre-defined disability change threshold (defined as trigger events and measured by Expanded Disability Status Scale, EDSS) during the double-blind treatment period were confirmed after 12 or 24 weeks, designating them confirmed disability worsening (CDW) events. The number of patients who had confirmed 12- or 24-weeks CDW events was 3.7% for patients receiving placebo and only 1.6% for patients receiving any dose of vidofludimus calcium.

Finally, the pooled data set also reinforced that vidofludimus calcium was well-tolerated, in general, and that its safety profile was similar to the placebo group. Across cohorts 1 and 2, a total of 268 patients were randomized to 10 mg (n=47), 30 mg (n=71), or 45 mg (n=69) of vidofludimus calcium or placebo (n=81).

1200 Avenue of the Americas Suite 200 New York, NY 10036