Laquinimod

Laquinimod is a tablet that was initially developed for relapsing MS but is now being tested for primary progressive MS. In 2014 it was refused a license for relapsing MS due to disappointing trial results, and in 2017 a phase 3 trial was discontinued.

 

Current phase of trial: phase 2

Type of MS: primary progressive

How does laquinimod work?

We don't fully understand how laquinimod works, but it is thought to alter the behaviour of immune cells, stopping them from entering the brain and spinal cord and damaging myelin.

Research suggests it could reduce inflammation and protect nerve structure and function.

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How is laquinimod taken?

As a once daily tablet.

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Latest research

Relapsing MS - CONCERTO

Initial results from the CONCERTO trial were announced in May 2017. Laquinimod did not slow disability progression compared with placebo and the trial has now been discontinued.

The trial aimed to test the benefits of two doses of laquinimod (0.6mg and 1.2mg) on disability progression in around 1,800 people with relapsing MS. The higher dose was removed due to safety concerns relating to cardiovascular side effects.

Primary progressive MS - ARPEGGIO

This phase 2 study aimed to test the benefits of 48 weeks of two doses of laquinimod (0.6mg and 1.5mg) compared with placebo in 375 people with primary progressive MS. Due to safety concerns the higher dose of laquinimod was removed.

The trial finished in 2017 and we expect results early in 2018. Researchers are looking for brain volume changes, progression of disability and new lesions measured by MRI to show whether the drug is effective .

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Earlier research - relapsing MS

BRAVO phase 3 trial

Laquinimod did not reduce relapse rates compared with placebo in this two year, phase 3 trial. But it did reduce rates of brain shrinkage and disability progression.

This study involved 1,331 people with relapsing MS, and compared the effects of 0.6mg of laquinimod with beta interferon (Avonex), and a placebo drug. Results were published in 2014.

>> Read more about the trial

ALLEGRO phase 3 trial

An earlier two year phase 3 trial in over 1100 people showed that a daily dose of 0.6mg of laquinimod reduced relapse rates by 23% and disability progression by 36% compared with placebo.

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What are the side effects of laquinimod?

Low-dose laquinimod was generally well tolerated. The most common side effects were headaches, back pain and colds. Some people also had elevated liver enzyme levels, but this was reported to be treatable.

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How does laquinimod compare with current therapies?

As part of the BRAVO phase 3 study laquinimod was compared to beta-interferon (Avonex), and it was found to reduce disability progression whereas beta-interferon had no significant impact on disability progression. However, beta-interferon led to a significant reduction in annualised relapse rate, while laquinimod did not.

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When is laquinimod likely to become available?

In 2014 laquinimod was refused a license for relapsing MS due to disappointing trial results. It's now being tested in another phase 3 trial, which is due to finish in 2019.

Laquinimod is also being tested in primary progressive MS, but this research is at an earlier stage.

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