Relapsing Forms of Multiple Sclerosis (RMS) Study of Bruton's Tyrosine Kinase (BTK) Inhibitor Tolebrutinib (SAR442168) (GEMINI 2)
NCT ID: NCT04410991
Last Updated: 2025-07-02
Study Results
Outcome measurements, participant flow, baseline characteristics, and adverse events have been published for this study.
View full resultsBasic Information
Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.
COMPLETED
PHASE3
899 participants
INTERVENTIONAL
2020-06-11
2024-07-16
Brief Summary
Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.
To assess efficacy of daily SAR442168 compared to a daily dose of 14 mg teriflunomide (Aubagio) measured by annualized adjudicated relapse rate (ARR) in participants with relapsing forms of MS
Secondary Objective:
To assess efficacy of SAR442168 compared to teriflunomide (Aubagio) on disability progression, MRI lesions, cognitive performance and quality of life To evaluate the safety and tolerability of daily SAR442168 To evaluate pharmacodynamics (PD) of SAR442168
Related Clinical Trials
Explore similar clinical trials based on study characteristics and research focus.
Relapsing Forms of Multiple Sclerosis (RMS) Study of Bruton's Tyrosine Kinase (BTK) Inhibitor Tolebrutinib (SAR442168) (GEMINI 1)
NCT04410978
Efficacy and Safety Studies of Frexalimab (SAR441344) in Adults With Relapsing Forms of Multiple Sclerosis
NCT06141473
Long Term Safety and Efficacy Study of Tolebrutinib (SAR442168) in Participants With Relapsing Multiple Sclerosis
NCT03996291
Nonrelapsing Secondary Progressive Multiple Sclerosis (NRSPMS) Study of Bruton's Tyrosine Kinase (BTK) Inhibitor Tolebrutinib (SAR442168) (HERCULES)
NCT04411641
A Study to Investigate Long-term Safety and Tolerability of Tolebrutinib in Participants With Multiple Sclerosis.
NCT06372145
Detailed Description
Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.
Conditions
See the medical conditions and disease areas that this research is targeting or investigating.
Study Design
Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.
RANDOMIZED
PARALLEL
TREATMENT
TRIPLE
Study Groups
Review each arm or cohort in the study, along with the interventions and objectives associated with them.
SAR442168
Dose 1 of oral SAR442168 daily + placebo to match the teriflunomide tablet once daily
Tolebrutinib
Pharmaceutical form: Tablet
Route of administration: Oral
Placebo to match Teriflunomide
Pharmaceutical form: Tablet
Route of administration: Oral
Teriflunomide
Oral 14 mg oral teriflunomide + placebo to match the SAR442168 tablet once daily
Teriflunomide HMR1726
Pharmaceutical form: Tablet
Route of administration: Oral
Placebo to match Tolebrutinib
Pharmaceutical form: Tablet
Route of administration: Oral
Interventions
Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.
Tolebrutinib
Pharmaceutical form: Tablet
Route of administration: Oral
Teriflunomide HMR1726
Pharmaceutical form: Tablet
Route of administration: Oral
Placebo to match Tolebrutinib
Pharmaceutical form: Tablet
Route of administration: Oral
Placebo to match Teriflunomide
Pharmaceutical form: Tablet
Route of administration: Oral
Other Intervention Names
Discover alternative or legacy names that may be used to describe the listed interventions across different sources.
Eligibility Criteria
Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.
Inclusion Criteria
* The participant must have been diagnosed with RMS according to the 2017 revision of the McDonald diagnostic criteria
* The participant has an expanded disability status scale (EDSS) score ≤5.5 at the first Screening Visit
* The participant must have at least 1 of the following prior to screening:
* ≥1 documented relapse within the previous year OR
* ≥2 documented relapses within the previous 2 years, OR
* ≥1 documented Gd enhancing lesion on an MRI scan within the previous year
* Contraceptive use by men or women should be consistent with local regulations regarding the methods of contraception for those participating in clinical studies
* Male participants are eligible to participate if they agree to the following during the intervention period and until accelerated elimination procedure:
* Refrain from donating sperm
Plus either:
* Be abstinent from heterosexual intercourse as their preferred and usual lifestyle (abstinent on a long term and persistent basis) and agree to remain abstinent OR
* Must agree to use contraception/barrier as detailed below
* Agree to use a male condom and should also be advised of the benefit for a female partner to use a highly effective method of contraception as a condom may break or leak when having sexual intercourse with a woman of childbearing potential (WOCBP) who is not currently pregnant
\- A female participant is eligible to participate if she is not pregnant or breastfeeding, and at least one of the following conditions apply:
* Is not a WOCBP OR
* Is a WOCBP and agrees to use a contraceptive method that is highly effective (with a failure rate of \<1% per year), preferably with low user dependency during the intervention period and until accelerated elimination procedure is completed (or for at least 10 days after the last dose of SAR442168, if the case was unblinded) and agrees not to donate eggs (ova, oocytes) for the purpose of reproduction during the study and for the same period of time.
* A WOCBP must have a negative highly sensitive pregnancy test at screening and within 24hours before the first dose of study intervention.
* If a urine test cannot be confirmed as negative (eg, an ambiguous result), a serum pregnancy test is required. In such cases, the participant must be excluded from participation if the serum pregnancy result is positive.
* The Investigator is responsible for review of medical history, menstrual history, and recent sexual activity to decrease the risk for inclusion of a woman with an early undetected pregnancy.
* The participant must have given written informed consent prior to undertaking any study related procedure. This includes consent to comply with the requirements and restrictions listed in the informed consent form (ICF) and in this protocol. In countries where the legal age of maturity is greater than 18 years, a specific ICF for such legally minor participants must also be signed by the participant's legally authorized representative
Exclusion Criteria
* The participant has a history of infection or may be at risk for infection including but not limited to: HIV, transplantation, live attenuated vaccines, progressive multifocal leukoencephalopathy, tuberculosis, hepatitis B or C, any persistent chronic or active recurring infection
* Clinically significant laboratory abnormalities (including evidence of liver injury) or electrocardiogram abnormalities at Screening.
* The participant has conditions or situations that would adversely affect participation in this study, including but not limited to:
* A short life expectancy due to pre-existing health condition(s) as determined by their treating neurologist
* Medical condition(s) or concomitant disease(s) making them nonevaluable for the primary efficacy endpoint or that would adversely affect participation in this study, as judged by the Investigator
* A requirement for concomitant treatment that could bias the primary evaluation
* The participant has a history of or currently has concomitant medical or clinical conditions that would adversely affect participation in this study
* At screening, the participant is positive for hepatitis B surface antigen and/or hepatitis B core antibody and/or is positive for hepatitis C antibody
* The participant has any of the following:
* A bleeding disorder or known platelet dysfunction at any time prior to the screening visit
* A platelet count \<150 000/μL at the screening visit
* The participant has a lymphocyte count below the lower limit of normal (LLN) at the screening visit
* The presence of psychiatric disturbance or substance abuse
* Prior/concomitant therapy
* The participant is receiving potent and moderate inducers of cytochrome P450 (CYP) 3A or potent inhibitors of CYP2C8 hepatic enzymes
* The participant is receiving anticoagulant/antiplatelet therapies
* The above information is not intended to contain all considerations relevant to a patient's potential participation in a clinical trial
18 Years
55 Years
ALL
No
Sponsors
Meet the organizations funding or collaborating on the study and learn about their roles.
Sanofi
INDUSTRY
Responsible Party
Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.
Principal Investigators
Learn about the lead researchers overseeing the trial and their institutional affiliations.
Clinical Sciences & Operations
Role: STUDY_DIRECTOR
Sanofi
Locations
Explore where the study is taking place and check the recruitment status at each participating site.
North Central Neurology Associates, PC-Site Number:8400009
Cullman, Alabama, United States
Center for Neurology and Spine-Site Number:8400089
Phoenix, Arizona, United States
Arcadia Neurology Center-Site Number:8400070
Arcadia, California, United States
Multiple Sclerosis Center of California-Site Number:8400135
Newport Beach, California, United States
Harbor UCLA-Site Number:8400088
Torrance, California, United States
Mountain Neurological Research Center, Inc.-Site Number:8400128
Basalt, Colorado, United States
Advanced Neurosciences Research-Site Number:8400025
Fort Collins, Colorado, United States
South Florida Neurology Associates-Site Number:8400029
Boca Raton, Florida, United States
University of Florida Health-Site Number:8400159
Gainesville, Florida, United States
Neurology Associates, PA-Site Number:8400004
Maitland, Florida, United States
University of Miami-Site Number:8400063
Miami, Florida, United States
Infinity Clinical Research-Site Number:8400008
Sunrise, Florida, United States
University of South Florida-Site Number:8400006
Tampa, Florida, United States
Meridian Clinical Research-Site Number:8400003
Savannah, Georgia, United States
Consultants In Neurology-Site Number:8400011
Northbrook, Illinois, United States
Prairie Education and Research Cooperative-Site Number:8400071
Springfield, Illinois, United States
Fort Wayne Neurological Center-Site Number:8400039
Fort Wayne, Indiana, United States
CHI Saint Joseph Medical Group Neurology-Site Number:8400110
Lexington, Kentucky, United States
University of Kentucky-Site Number:8400106
Lexington, Kentucky, United States
Norton Neurology MS Services-Site Number:8400127
Louisville, Kentucky, United States
The NeuroMedical Center-Site Number:8400057
Baton Rouge, Louisiana, United States
International Neurorehabilitation Institute-Site Number:8400034
Lutherville-Timonium, Maryland, United States
Wayne State University-Site Number:8400046
Detroit, Michigan, United States
Minneapolis Clinic of Neurology-Site Number:8400051
Minneapolis, Minnesota, United States
Saint Luke's Hospital-Site Number:8400153
Kansas City, Missouri, United States
West Omaha Family Physicians-Site Number:8400139
Omaha, Nebraska, United States
University Of Nebraska-Site Number:8400129
Omaha, Nebraska, United States
Hackensack University Hospital-Site Number:8400047
Hackensack, New Jersey, United States
University of New Mexico-Site Number:8400032
Albuquerque, New Mexico, United States
South Shore Neurologic Associates-Site Number:8400100
Patchogue, New York, United States
Novant Health Multiple Sclerosis Care Center - South Park-Site Number:8400120
Charlotte, North Carolina, United States
Meridian Clinical Research, LLC-Site Number:8400005
Raleigh, North Carolina, United States
Sanford Brain & Spine Center-Site Number:8400126
Fargo, North Dakota, United States
Dayton Center for Neurological Disorders-Site Number:8400081
Centerville, Ohio, United States
Jefferson Neurology Associates-Site Number:8400016
Philadelphia, Pennsylvania, United States
Premier Neurology-Site Number:8400069
Greer, South Carolina, United States
Advanced Neuroscience Center-Site Number:8400035
Franklin, Tennessee, United States
Sibyl Wray, MD, Neurology, PC-Site Number:8400007
Knoxville, Tennessee, United States
Mt Olympus Medical Research-Site Number:8400163
Katy, Texas, United States
Neurology Center of San Antonio-Site Number:8400036
San Antonio, Texas, United States
Texas Institute for Neuroogical Disorders-Sherman-Site Number:8400151
Sherman, Texas, United States
Neurological Associates-Site Number:8400097
Richmond, Virginia, United States
Wheaton Franciscan Healthcare-Site Number:8400022
Milwaukee, Wisconsin, United States
Investigational Site Number :0320004
CABA, Buenos Aires, Argentina
Investigational Site Number :0320002
Capital Federal, Buenos Aires, Argentina
Investigational Site Number :0320001
CABA, Buenos Aires F.D., Argentina
Investigational Site Number :0320003
Rosario, Santa Fe Province, Argentina
Investigational Site Number :0320005
San Miguel de Tucumán, , Argentina
Investigational Site Number :0560005
Bruges, , Belgium
Investigational Site Number :0560004
Ghent, , Belgium
Investigational Site Number :0560002
Mons, , Belgium
Investigational Site Number :0560001
Overpelt, , Belgium
Investigational Site Number :0760001
Porto Alegre, Rio Grande do Sul, Brazil
Investigational Site Number :0760002
Curitiba, , Brazil
Investigational Site Number :0760007
São Paulo, , Brazil
Investigational Site Number :1240002
Edmonton, Alberta, Canada
Investigational Site Number : 1240012
Hamilton, Ontario, Canada
Investigational Site Number :1240014
London, Ontario, Canada
Investigational Site Number :1240005
Greenfield Park, Quebec, Canada
Investigational Site Number :1240006
Gatineau, , Canada
Investigational Site Number :1240021
Québec, , Canada
Investigational Site Number :1520002
Santiago, Reg Metropolitana de Santiago, Chile
Investigational Site Number :1520005
Santiago, Reg Metropolitana de Santiago, Chile
Investigational Site Number :1520001
Santiago, Reg Metropolitana de Santiago, Chile
Investigational Site Number :1520003
Santiago, Reg Metropolitana de Santiago, Chile
Investigational Site Number :1520006
Concepción, , Chile
Investigational Site Number :1520004
Valdivia, , Chile
Investigational Site Number :1910001
Zagreb, , Croatia
Investigational Site Number :1910002
Zagreb, , Croatia
Investigational Site Number :1910003
Zagreb, , Croatia
Investigational Site Number :2030002
Brno, , Czechia
Investigational Site Number :2030011
Hradec Králové, , Czechia
Investigational Site Number :2030001
Jihlava, , Czechia
Investigational Site Number :2030008
Prague, , Czechia
Investigational Site Number :2030005
Praha 5 - Motol, , Czechia
Investigational Site Number :2500019
Besançon, , France
Investigational Site Number :2500018
Bordeaux, , France
Investigational Site Number :2500011
Bron, , France
Investigational Site Number :2500005
Clermont-Ferrand, , France
Investigational Site Number :2500006
Montpellier, , France
Investigational Site Number :2500010
Nantes, , France
Investigational Site Number :2500002
Nice, , France
Investigational Site Number :2500017
Nîmes, , France
Investigational Site Number :2500007
Paris, , France
Investigational Site Number :2500004
Poissy, , France
Investigational Site Number :2500003
Rennes, , France
Investigational Site Number :2500001
Strasbourg, , France
Investigational Site Number :2760005
Bayreuth, , Germany
Investigational Site Number :2760015
Berlin, , Germany
Investigational Site Number :2760014
Berlin, , Germany
Investigational Site Number :2760020
Bochum, , Germany
Investigational Site Number :2760012
Essen, , Germany
Investigational Site Number :2760003
Würzburg, , Germany
Investigational Site Number :3000001
Athens, , Greece
Investigational Site Number :3000006
Athens, , Greece
Investigational Site Number :3000002
Athens, , Greece
Investigational Site Number :3000007
Athens, , Greece
Investigational Site Number :3000009
Athens, , Greece
Investigational Site Number :3000004
Larissa, , Greece
Investigational Site Number :3000003
Thessaloniki, , Greece
Investigational Site Number :3480105
Budapest, , Hungary
Investigational Site Number :3480102
Budapest, , Hungary
Investigational Site Number :3480106
Kaposvár, , Hungary
Investigational Site Number :3480103
Tatabánya, , Hungary
Investigational Site Number :3560005
Chandigarh, , India
Investigational Site Number :3560007
Gurgaon, , India
Investigational Site Number :3560008
Gurgaon, , India
Investigational Site Number :3560002
New Delhi, , India
Investigational Site Number :3560004
Thiruvananthapuram, , India
Investigational Site Number :3760002
Ashkelon, , Israel
Investigational Site Number :3760003
Haifa, , Israel
Investigational Site Number :3760006
Rehovot, , Israel
Investigational Site Number :3760004
Safed, , Israel
Investigational Site Number :3760001
Tel Litwinsky, , Israel
Investigational Site Number :4280002
Riga, , Latvia
Investigational Site Number :4280003
Riga, , Latvia
Investigational Site Number :5280001
Amsterdam, , Netherlands
Investigational Site Number :5780002
Namsos, , Norway
Investigational Site Number :5780001
Oslo, , Norway
Investigational Site Number :6200001
Braga, , Portugal
Investigational Site Number :6200005
Coimbra, , Portugal
Investigational Site Number :6200011
Lisbon, , Portugal
Investigational Site Number :6200006
Lisbon, , Portugal
Investigational Site Number :6200002
Matosinhos Municipality, , Portugal
Investigational Site Number :6200010
Porto, , Portugal
Investigational Site Number :6200004
Santa Maria da Feira, , Portugal
San Juan MS Center-Site Number:8400015
Guaynabo, , Puerto Rico
Investigational Site Number :6430006
Barnaul, , Russia
Investigational Site Number :6430013
Bryansk, , Russia
Investigational Site Number :6430001
Kazan', , Russia
Investigational Site Number :6430010
Kirov, , Russia
Investigational Site Number :6430007
Moscow, , Russia
Investigational Site Number :6430005
Moscow, , Russia
Investigational Site Number :6430003
Novosibirsk, , Russia
Investigational Site Number :6430014
Saint Petersburg, , Russia
Investigational Site Number :6430004
Saint Petersburg, , Russia
Investigational Site Number :6430002
Saint Petersburg, , Russia
Investigational Site Number :6430011
Saransk, , Russia
Investigational Site Number :6430012
Yekaterinburg, , Russia
Investigational Site Number :6880001
Belgrade, , Serbia
Investigational Site Number :6880003
Belgrade, , Serbia
Investigational Site Number :6880006
Belgrade, , Serbia
Investigational Site Number :6880002
Kragujevac, , Serbia
Investigational Site Number :6880004
Niš, , Serbia
Investigational Site Number :6880005
Novi Sad, , Serbia
Investigational Site Number :7030001
Bratislava, , Slovakia
Investigational Site Number :7030002
Martin, , Slovakia
Investigational Site Number :7030004
Nitra, , Slovakia
Investigational Site Number :4100001
Goyang-si, Gyeonggi-do, South Korea
Investigational Site Number :4100003
Seoul, Seoul-teukbyeolsi, South Korea
Investigational Site Number :4100006
Seoul, Seoul-teukbyeolsi, South Korea
Investigational Site Number :4100002
Seoul, Seoul-teukbyeolsi, South Korea
Investigational Site Number :7240011
Seville, Andalusia, Spain
Investigational Site Number :7240006
Barcelona, Barcelona [Barcelona], Spain
Investigational Site Number :7240009
Barakaldo, Bizkaia, Spain
Investigational Site Number :7240004
Salt, Girona [Gerona], Spain
Investigational Site Number :7240013
Las Palmas de Gran Canaria, Las Palmas, Spain
Investigational Site Number :7240008
A Coruña, , Spain
Investigational Site Number :7240007
L'Hospitalet de Llobregat, , Spain
Investigational Site Number :7240005
Lleida, , Spain
Investigational Site Number :7240003
Madrid, , Spain
Investigational Site Number :7240001
Madrid, , Spain
Investigational Site Number :7240002
Madrid, , Spain
Investigational Site Number :7240010
Málaga, , Spain
Investigational Site Number :7240012
Pozuelo de Alarcón, , Spain
Investigational Site Number :7560003
Aarau, , Switzerland
Investigational Site Number :7560002
Bern, , Switzerland
Investigational Site Number :7560004
Lugano, , Switzerland
Investigational Site Number :7920002
Ankara, , Turkey (Türkiye)
Investigational Site Number :7920005
Besevler / Ankara, , Turkey (Türkiye)
Investigational Site Number :7920006
Istanbul, , Turkey (Türkiye)
Investigational Site Number :7920004
Kuttahta, , Turkey (Türkiye)
Investigational Site Number :7920001
Samsun, , Turkey (Türkiye)
Investigational Site Number :7920003
Trabzon, , Turkey (Türkiye)
Investigational Site Number :8040020
Chernihiv, , Ukraine
Investigational Site Number :8040002
Chernivtsi, , Ukraine
Investigational Site Number :8040019
Chernivtsi, , Ukraine
Investigational Site Number :8040005
Dnipro, , Ukraine
Investigational Site Number :8040022
Kharkiv, , Ukraine
Investigational Site Number :8040018
Kharkiv, , Ukraine
Investigational Site Number :8040007
Kyiv, , Ukraine
Investigational Site Number :8040006
Lviv, , Ukraine
Investigational Site Number :8040003
Vinnytsia, , Ukraine
Investigational Site Number :8260003
Exeter, Devon, United Kingdom
Investigational Site Number :8260016
Canterbury, Kent, United Kingdom
Investigational Site Number :8260009
Bristol, , United Kingdom
Countries
Review the countries where the study has at least one active or historical site.
References
Explore related publications, articles, or registry entries linked to this study.
Oh J, Arnold DL, Cree BAC, Ionete C, Kim HJ, Sormani MP, Syed S, Chen Y, Maxwell CR, Benoit P, Turner TJ, Wallstroem E, Wiendl H; Tolebrutinib Phase 3 GEMINI 1 and 2 Trial Group. Tolebrutinib versus Teriflunomide in Relapsing Multiple Sclerosis. N Engl J Med. 2025 May 15;392(19):1893-1904. doi: 10.1056/NEJMoa2415985. Epub 2025 Apr 8.
Provided Documents
Download supplemental materials such as informed consent forms, study protocols, or participant manuals.
Document Type: Study Protocol
Document Type: Statistical Analysis Plan
Related Links
Access external resources that provide additional context or updates about the study.
EFC16034 Plain language Results Summary
Other Identifiers
Review additional registry numbers or institutional identifiers associated with this trial.
U1111-1238-1373
Identifier Type: REGISTRY
Identifier Source: secondary_id
2020-000644-55
Identifier Type: EUDRACT_NUMBER
Identifier Source: secondary_id
EFC16034
Identifier Type: -
Identifier Source: org_study_id
More Related Trials
Additional clinical trials that may be relevant based on similarity analysis.