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Last Updated: January 17, 2025

CLINICAL TRIALS PROFILE FOR TECFIDERA


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All Clinical Trials for Tecfidera

Trial ID Title Status Sponsor Phase Start Date Summary
NCT00273364 ↗ Stem Cell Therapy for Patients With Multiple Sclerosis Failing Alternate Approved Therapy- A Randomized Study Completed Sheffield Teaching Hospitals NHS Foundation Trust Phase 2 2005-11-16 Multiple sclerosis (MS) is at onset an immune-mediated demyelinating disease. In most cases, it starts as a relapsing-remitting disease with distinct attacks and no symptoms between flares. Over years or decades, virtually all cases transition into a progressive disease in which insidious and slow neurologic deterioration occurs with or without acute flares. Relapsing-remitting disease is often responsive to immune suppressive or modulating therapies, while immune based therapies are generally ineffective in patients with a progressive clinical course. This clinical course and response to immune suppression, as well as neuropathology and neuroimaging studies, suggest that disease progression is associated with axonal atrophy. Disability correlates better with measures of axonal atrophy than immune mediated demyelination. Therefore, immune based therapies, in order to be effective, need to be started early in the disease course while MS is predominately an immune-mediated and inflammatory disease. While current immune based therapies delay disability, no intervention has been proven to prevent progressive disability. We propose, as a randomized study, autologous unmanipulated PBSCT using a conditioning regimen of cyclophosphamide and rabbit antithymocyte globulin (rATG) versus FDA approved standard of care (i.e. interferon, glatiramer acetate, mitoxantrone, natalizumab, fingolimod, or tecfidera) in patients with inflammatory (relapsing) MS despite treatment with alternate approved therapy.
NCT00273364 ↗ Stem Cell Therapy for Patients With Multiple Sclerosis Failing Alternate Approved Therapy- A Randomized Study Completed University of Sao Paulo Phase 2 2005-11-16 Multiple sclerosis (MS) is at onset an immune-mediated demyelinating disease. In most cases, it starts as a relapsing-remitting disease with distinct attacks and no symptoms between flares. Over years or decades, virtually all cases transition into a progressive disease in which insidious and slow neurologic deterioration occurs with or without acute flares. Relapsing-remitting disease is often responsive to immune suppressive or modulating therapies, while immune based therapies are generally ineffective in patients with a progressive clinical course. This clinical course and response to immune suppression, as well as neuropathology and neuroimaging studies, suggest that disease progression is associated with axonal atrophy. Disability correlates better with measures of axonal atrophy than immune mediated demyelination. Therefore, immune based therapies, in order to be effective, need to be started early in the disease course while MS is predominately an immune-mediated and inflammatory disease. While current immune based therapies delay disability, no intervention has been proven to prevent progressive disability. We propose, as a randomized study, autologous unmanipulated PBSCT using a conditioning regimen of cyclophosphamide and rabbit antithymocyte globulin (rATG) versus FDA approved standard of care (i.e. interferon, glatiramer acetate, mitoxantrone, natalizumab, fingolimod, or tecfidera) in patients with inflammatory (relapsing) MS despite treatment with alternate approved therapy.
NCT00273364 ↗ Stem Cell Therapy for Patients With Multiple Sclerosis Failing Alternate Approved Therapy- A Randomized Study Completed Uppsala University Phase 2 2005-11-16 Multiple sclerosis (MS) is at onset an immune-mediated demyelinating disease. In most cases, it starts as a relapsing-remitting disease with distinct attacks and no symptoms between flares. Over years or decades, virtually all cases transition into a progressive disease in which insidious and slow neurologic deterioration occurs with or without acute flares. Relapsing-remitting disease is often responsive to immune suppressive or modulating therapies, while immune based therapies are generally ineffective in patients with a progressive clinical course. This clinical course and response to immune suppression, as well as neuropathology and neuroimaging studies, suggest that disease progression is associated with axonal atrophy. Disability correlates better with measures of axonal atrophy than immune mediated demyelination. Therefore, immune based therapies, in order to be effective, need to be started early in the disease course while MS is predominately an immune-mediated and inflammatory disease. While current immune based therapies delay disability, no intervention has been proven to prevent progressive disability. We propose, as a randomized study, autologous unmanipulated PBSCT using a conditioning regimen of cyclophosphamide and rabbit antithymocyte globulin (rATG) versus FDA approved standard of care (i.e. interferon, glatiramer acetate, mitoxantrone, natalizumab, fingolimod, or tecfidera) in patients with inflammatory (relapsing) MS despite treatment with alternate approved therapy.
>Trial ID >Title >Status >Phase >Start Date >Summary

Clinical Trial Conditions for Tecfidera

Condition Name

Condition Name for Tecfidera
Intervention Trials
Multiple Sclerosis 24
Relapsing-remitting Multiple Sclerosis 13
Multiple Sclerosis, Relapsing-Remitting 9
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Condition MeSH

Condition MeSH for Tecfidera
Intervention Trials
Multiple Sclerosis 51
Sclerosis 43
Multiple Sclerosis, Relapsing-Remitting 27
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Clinical Trial Locations for Tecfidera

Trials by Country

Trials by Country for Tecfidera
Location Trials
United States 360
France 40
Canada 27
United Kingdom 25
Germany 22
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Trials by US State

Trials by US State for Tecfidera
Location Trials
Texas 17
North Carolina 16
New York 16
California 16
Washington 15
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Clinical Trial Progress for Tecfidera

Clinical Trial Phase

Clinical Trial Phase for Tecfidera
Clinical Trial Phase Trials
Phase 4 19
Phase 3 11
Phase 2 9
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Clinical Trial Status

Clinical Trial Status for Tecfidera
Clinical Trial Phase Trials
Completed 29
Terminated 14
Withdrawn 4
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Clinical Trial Sponsors for Tecfidera

Sponsor Name

Sponsor Name for Tecfidera
Sponsor Trials
Biogen 39
EMD Serono 3
Sheffield Teaching Hospitals NHS Foundation Trust 3
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Sponsor Type

Sponsor Type for Tecfidera
Sponsor Trials
Industry 51
Other 35
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Tecfidera: Clinical Trials Update, Market Analysis, and Projections

Introduction to Tecfidera

Tecfidera, also known as dimethyl fumarate, is an oral medication approved for the treatment of relapsing forms of multiple sclerosis (MS), including relapsing-remitting MS (RRMS). Developed by Biogen, Tecfidera has been a significant player in the MS treatment market since its approval in 2013.

Clinical Trials Update

Ongoing and Completed Trials

Tecfidera has undergone extensive clinical trials to establish its efficacy and safety profile. Here are some key updates:

  • DEFINE and CONFIRM Trials: These Phase 3 clinical trials demonstrated that Tecfidera significantly reduced the annualized relapse rate (ARR) by 63% compared to placebo and reduced the risk of 12-week confirmed disability progression[3].
  • ENDORSE Study: This ongoing global, dose-blind, Phase 3 extension study is evaluating the long-term safety and efficacy of Tecfidera. It has enrolled 1,738 patients with RRMS and aims to follow them for up to eight years to assess long-term clinical outcomes and quality of life measurements[3].

Emerging Therapeutic Combinations

Recent research suggests that combining Tecfidera with other therapies could enhance its therapeutic benefits:

  • Immune Tolerizing Cell Therapy: A study indicates that adding Tecfidera to immune tolerizing cell therapy using tolerogenic dendritic cells (tolDCs) may maximize therapeutic benefits for MS patients. This combination showed promise in reducing disease severity and improving immune cell profiles in both lab studies and a mouse model of MS[4].

Market Analysis

Market Protection in Europe

The European Commission's recent decision has significantly impacted the market dynamics for Tecfidera:

  • Revocation of Generic Approvals: The EC revoked the marketing authorizations for generic versions of Tecfidera held by companies such as Accord Healthcare, Mylan, Neuraxpharm, Polpharma, and Teva Pharmaceuticals. This decision grants Biogen full data and marketing protection for Tecfidera until February 3, 2025[2][5].

Impact on Sales and Revenue

  • Revenue Decline: The entry of generic versions in the U.S. and certain European countries led to a sharp decline in Tecfidera's revenue, from $4.4 billion in 2019 to $1.4 billion in 2022. However, the EC's decision is expected to stabilize sales, at least in Europe, until early 2025[2][5].
  • Current Market Position: Despite the decline, Tecfidera still accounts for a meaningful share of Biogen's revenue, approximately 14% through the first nine months of 2023, primarily driven by ex-U.S. sales[2].

Global Usage

Tecfidera remains the most-prescribed oral MS medication globally, with over 170,000 patients treated worldwide since its approval. Its strong, sustained efficacy and well-established safety profile have made it a preferred treatment option for many patients with RRMS[3].

Projections and Future Outlook

Market Protection and Sales

  • Short-Term Stability: The EC's decision to revoke generic approvals will help maintain Tecfidera's market position in Europe until early 2025. This is expected to stabilize sales and potentially revive revenue to some extent[2][5].
  • Long-Term Challenges: After the market protection expires, Biogen will face increased competition from generic versions, which could further erode Tecfidera's market share and revenue.

Emerging Therapies and Combinations

  • Combination Therapies: The potential of combining Tecfidera with immune tolerizing cell therapy or other targeted therapies could open new avenues for treatment and maintain its relevance in the MS treatment landscape[4].

Competitive Landscape

  • Other MS Treatments: Biogen's portfolio includes other MS treatments like Tysabri, which is currently the company's top-seller. However, Tysabri may soon face biosimilar competition, making the continued success of Tecfidera crucial for Biogen's MS business[2].

Key Takeaways

  • Clinical Efficacy: Tecfidera has demonstrated strong efficacy in reducing relapse rates and slowing disease progression in MS patients.
  • Market Protection: The EC's decision to revoke generic approvals will protect Tecfidera's market position in Europe until early 2025.
  • Global Usage: Tecfidera remains the most-prescribed oral MS medication globally.
  • Future Outlook: The drug faces long-term challenges from generic competition but may find new life through combination therapies.

FAQs

What is Tecfidera used for?

Tecfidera is an oral medication used for the treatment of relapsing forms of multiple sclerosis (MS), including relapsing-remitting MS (RRMS)[3].

How effective is Tecfidera in treating MS?

Tecfidera has been shown to reduce the annualized relapse rate by 63% and the risk of 12-week confirmed disability progression compared to placebo[3].

Why did the European Commission revoke generic approvals for Tecfidera?

The EC revoked generic approvals to grant Biogen an additional year of exclusivity for a pediatric indication, ensuring Tecfidera's market protection until February 3, 2025[2][5].

How many patients have been treated with Tecfidera worldwide?

Over 170,000 patients have been treated with Tecfidera worldwide since its approval[3].

What are the potential future therapeutic combinations for Tecfidera?

Research suggests that combining Tecfidera with immune tolerizing cell therapy could maximize therapeutic benefits for MS patients[4].

Sources

  1. MSAA - What's New in MS Research - September 2024
  2. Biopharma Dive - Biogen holds onto Tecfidera market in Europe for a little longer
  3. MS Care - Data show effects of TECFIDERA in newly-diagnosed and early disease course multiple sclerosis patients
  4. Multiple Sclerosis News Today - Tecfidera with immune tolerizing cell therapy shows promise for MS
  5. Pharmaceutical Technology - Biogen fend off generics of MS drug Tecfidera in Europe until 2025

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