CONCERTO: A randomized, placebo-controlled trial of oral laquinimod in relapsing-remitting multiple sclerosis.

Multiple sclerosis (Houndmills, Basingstoke, England) 2022 Apr

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Interventions targeting the adaptive immune response are needed in multiple sclerosis (MS). Evaluate laquinimod's efficacy, safety, and tolerability in patients with relapsing-remitting multiple sclerosis (RRMS). CONCERTO was a randomized, double-blind, placebo-controlled, phase-3 study. RRMS patients were randomized 1:1:1 to receive once-daily oral laquinimod 0.6 or 1.2 mg or placebo for ⩽24 months (n = 727, n = 732, and n = 740, respectively). Primary endpoint was time to 3-month confirmed disability progression (CDP). The laquinimod 1.2-mg dose arm was discontinued (1 January 2016) due to cardiovascular events at high doses. Safety was monitored throughout the study. CONCERTO did not meet the primary endpoint of significant effect with laquinimod 0.6-mg versus placebo on 3-month CDP (hazard ratio: 0.94; 95% confidence interval: 0.67-1.31; p = 0.706). Secondary endpoint p values were nominal and non-inferential. Laquinimod 0.6 mg demonstrated 40% reduction in percent brain volume change from baseline to Month 15 versus placebo (p < 0.0001). The other secondary endpoint, time to first relapse, and annualized relapse rate (an exploratory endpoint) were numerically lower (both, p = 0.0001). No unexpected safety findings were reported with laquinimod 0.6 mg. Laquinimod 0.6 mg demonstrated only nominally significant effects on clinical relapses and magnetic resonance imaging (MRI) outcomes and was generally well tolerated. ClinicalTrials.gov (NCT01707992).

Citation

Giancarlo Comi, Yuval Dadon, Nissim Sasson, Joshua R Steinerman, Volker Knappertz, Timothy L Vollmer, Alexey Boyko, Patrick Vermersch, Tjalf Ziemssen, Xavier Montalban, Fred D Lublin, Maria A Rocca, Rita Volkinshtein, Svetlana Rubinchick, Nitsan Halevy, Massimo Filippi. CONCERTO: A randomized, placebo-controlled trial of oral laquinimod in relapsing-remitting multiple sclerosis. Multiple sclerosis (Houndmills, Basingstoke, England). 2022 Apr;28(4):608-619