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NCT07299019PHASE3Recruiting

A Study of Orelabrutinib in Patients With Secondary Progressive Multiple Sclerosis

Zenas BioPharma (USA), LLC

Start Date

3/23/2026

Completion Date

7/1/2030

Summary

Orelabrutinib is a CNS-penetrable BTK inhibitor. This is a phase 3, randomized, double-blind, parallel-group, multicenter study to evaluate the efficacy and safety of orelabrutinib compared with placebo in patients with non-active Secondary Progress MS. Patients will be treated for approximately 24 to 60 months, with a minimum treatment duration of 12 months. The study will enroll approximately 990 subjects in a 2:1 randomization (orelabrutinib: placebo), globally.

Detailed Description

This is a phase 3, randomized, double-blind, parallel-group, multicenter study to evaluate the efficacy and safety of orelabrutinib compared with placebo in patients with naSPMS. The study will enroll approximately 990 subjects in a 2:1 randomization (orelabrutinib: placebo), globally. The study consists of the following periods: * Screening Period: Up to 4 weeks. * Treatment Period: The duration of treatment will vary for individual participants ranging from approximately 24 to 60 months, depending on the time of recruitment. A month is defined as a period of 28 days by convention. * Double-blinded (DB) Treatment: All eligible participants will be randomized at 2:1 ratio to accept orelabrutinib QD or placebo during the DB treatment period. The study will be unblinded when all participants in the DB period have reached a minimum treatment duration of 12 months at the time of primary analysis timing cutoff. * Open-label (OL) Treatment: Participants with 24-week CDP as assessed by EDSS are eligible for 2-year open-label orelabrutinib treatment. * Safety Follow-Up Period: It will last 4 weeks. The safety follow-up period will begin when the participants discontinue from the treatment before the end of the trial for any reasons or complete the trial but do not enter the long-term safety study (LTS) (see below). All active study participants will have a final end of study (EOS) visit within 4 weeks of the study end date. Participants who are receiving IMP in DB or OL but do not consent to or are not eligible for enrollment in the LTS study, must return for a final safety follow-up visit 4 weeks later. For participants who intend and are eligible to join the LTS, open-label treatment with orelabrutinib will continue and no safety follow-up will occur.

Eligibility Criteria

Age Range: 18 years to 60 years

Inclusion Criteria: 1. 18 to 60 years of age, inclusive, at the time of signing the informed consent. 2. Participant must have a previous diagnosis of RRMS in accordance with 2024 McDonald criteria 3. Participant must have a current diagnosis of SPMS in accordance with the clinical course criteria revised in 2013 4. Participant must have documented evidence of disability progression independent of clinical relapse observed during the 24 months before screening. A written summary of the clinical evidence of disability progression must be discussed and aligned between the Investigator and the Sponsor's dedicated qualified person(s). 5. Absence of clinical relapses for at least 24 months. Exclusion Criteria: 1. The patient has been diagnosed with primary progressive MS (PPMS) according to 2024 McDonald diagnostic criteria 2. Immunologic disorder other than MS or any other conditions requiring corticosteroid therapy. 3. History or current diagnosis of other neurological disorders that may mimic MS 4. History or current diagnosis of progressive multifocal leukoencephalopathy 5. Active, clinically significant viral, bacterial, or fungal infection 6. History of any other significant active medical condition 7. History of suicidal behavior within 6 months prior to Screening 8. Any prior history of malignancy 9. Patients on anticoagulation, or antiplatelet therapy 10. Patients took strong/moderate CYP3A inhibitors or strong/moderate CYP3A inducers within 14 days 11. Clinically significant laboratory abnormalities at Screening. 12. Vaccination with live or live-attenuated virus vaccine within 1 month prior to Screening 13. History of alcohol abuse or alcohol use disorder or other drug abuse within 12 months prior to screening.

Interventions

DRUG

Orelabrutinib

DRUG

Placebo

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Conditions

Secondary Progressive Multiple Sclerosis

Locations

Arizona Neuroscience Research, LLC

Phoenix, Arizona 85032

United States

Perseverance Research Center, LLC (PRC)

Scottsdale, Arizona 85253

United States

Fullerton Neurology and Headache Center

Fullerton, California 92835

United States

Regina Berkovich MD, PhD Inc

West Hollywood, California 90048

United States

SFM Clinical Research, LLC

Boca Raton, Florida 33487

United States

Nova Clinical Research, LLC

Bradenton, Florida 34209

United States

MS and Neuromuscular Center of Excellence

Clearwater, Florida 33761

United States

Neurology Associates

Maitland, Florida 32751

United States

Aqualane Clinical Research

Naples, Florida 34105

United States

Josephson Wallack Munshower Neurology, Pc Suite 225

Indianapolis, Indiana 46256

United States

KC Research Center, PA Neurology Research Dept

Roeland Park, Kansas 66205

United States

Boston Clinical Trials

Boston, Massachusetts 02131

United States

Profound Research LLC at Oakland Neurology Center

Rochester Hills, Michigan 48307

United States

Washington University School of Medicine

St Louis, Missouri 63110

United States

The Boster Center for Multiple Sclerosis

Columbus, Ohio 43235

United States

OMRF Multiple Sclerosis Center of Excellence

Oklahoma City, Oklahoma 73104

United States

Premier Neurology

Greenville, South Carolina 29605

United States

Lone Star Neurology

San Antonio, Texas 78258

United States

Texas Institute for Neurological Disorders - Sherman

Sherman, Texas 75092

United States

Twoja Przychodnia Centrum Medyczne Nowa Sól

Nowa Sól, Lubusz Voivodeship 67-100

Poland

Nmedis sp. z o.o.

Rzeszów, Rzeszów 35-323

Poland

NZOZ Novo Med

Katowice, Silesian Voivodeship 40-584

Poland

Galen Clinic

Lublin, 20-064

Poland