EMD Serono to Showcase Scientific Leadership at ECTRIMS 2019 with New Data Across Multiple Sclerosis Medicines

ROCKLAND, Mass., Aug. 28, 2019 /PRNewswire/ -- EMD Serono, the biopharmaceutical business of Merck KGaA, Darmstadt, Germany, in the U.S. and Canada, today announced that it will present data on its approved and investigational multiple sclerosis (MS) treatments at the 35(th) Congress of the European Committee for Treatment and Research In Multiple Sclerosis (ECTRIMS). During ECTRIMS, taking place from September 11-13, 2019, in Stockholm, Sweden, EMD Serono will present 39 abstracts, including new long-term safety and efficacy data on MAVENCLAD(®) (cladribine) tablets and new long-term efficacy data for interferon beta (IFN ) therapies, including Rebif(®) (interferon beta-1a). Data will also be presented further elucidating the proposed mechanism of action for investigational therapy evobrutinib, the first oral, highly selective Bruton's Tyrosine Kinase (BTK) inhibitor to demonstrate clinical proof of concept in relapsing multiple sclerosis (RMS).

"The new data we will be sharing at ECTRIMS touch on several important topics for the scientific community, including long-term safety and efficacy data for MAVENCLAD, long-term efficacy data for interferon beta therapies, including Rebif, and data further elucidating evobrutinib's proposed unique mechanism of action and its potential as a novel therapeutic approach in MS," said Luciano Rossetti, Head of Global R&D for EMD Serono. "These data reinforce the important role of our currently-available treatments and offer further insights on our investigational treatment, as we continue our unwavering commitment to address the needs of the MS community."

Key MAVENCLAD data include:

    --  A post hoc analysis evaluating five-year disease stability in patients
        enrolled in the CLARITY and CLARITY EXTENSION trials
    --  Results from an exploratory analysis of real-world data from an Italian
        MS registry assessing time-to-treatment change after MAVENCLAD, which
        examined efficacy of MAVENCLAD on relapse rate and disability
        progression at five years after starting treatment
    --  Results from up to 10 years of follow-up from the PREMIERE safety
        registry, which further support the long-term benefit-risk profile of
        MAVENCLAD
    --  New data further illustrating how MAVENCLAD is thought to preferentially
        target key immune cells involved with MS and its potential qualitative
        effect on the immune system

Key Rebif data include:

    --  Results using a new post hoc exploratory statistical methodology, which
        examined changes in disability status over time using eight years of
        data from the PRISMS study

Key evobrutinib data include:

    --  Three analyses that investigate the potential role of evobrutinib, the
        first oral, highly selective BTK inhibitor to demonstrate clinical proof
        of concept in RMS, in inhibiting pathogenic B-cells and promoting myelin
        repair

Additional EMD Serono activities at ECTRIMS 2019:

    --  Panel discussion and networking event on September 11 bringing together
        Patient Advocacy Groups, people living with MS and multi-disciplinary
        experts to have a conversation about family planning with MS (6:00 -
        7:30 PM, Epicenter, Stockholm)
    --  Daily "Meet the Expert" sessions at EMD Serono booth B40 where different
        MS experts will share insights from clinical practice with MAVENCLAD,
        explore family planning for patients with MS and the company`s ongoing
        commitment to MS research and development through the Grant for Multiple
        Sclerosis Innovation (GMSI)
    --  Satellite symposium events on September 11 (12:30 - 1:30 PM, Hall A
        Stockholmsmässan) and September 12 (6:15 - 7:15 PM, Hall A
        Stockholmsmässan) covering key learnings on managing disease
        progression in MS, including monitoring methods, recent advancements in
        MS immune targeting and the importance of innovative registry studies
    --  #MSInsideOut Experience, including the MS House and virtual reality
        (VR), at EMD Serono booth B40 that will immerse visitors into a
        day-in-the-life of an MS patient, educating them on symptoms of MS and
        how they affect the human body in different settings

Below is a selection of abstracts that have been accepted for presentation at ECTRIMS 2019:



            
              MAVENCLAD(R) (cladribine) tablets Presentations

    ---


            
              Title                                                     Authors      
            
              Abstract No.                         Presentation Date/Time/Session
                                                                                             / Poster No.

    ---                                                                                                                                                                                 ---


            Reduction of risk of                             
            Vermersch P,                   
            A-1026-0005-         
            Session Title: Poster
    secondary progressive                                     Giovannoni G,                                                 00522    Session 1
    multiple sclerosis within                                 Soelberg-Sorensen P,
    two years of treatment                                    Rammohan K, Cook S,                                                   
            Session Date:
    with Cladribine Tablets:                                  Keller B, Roy S                                                       09.11.2019
    An analysis of the
    CLARITY study                                                                                                                 
            Presenting Time:
                                                                                                                                  5:15-7:15 PM

    ---                                                                                                                                                                                 ---

             Long-term disease stability assessed                      Giovannoni G, Comi G,
              by the Expanded Disability Status                         Rammohan K,
              Scale in patients treated with                            Rieckmann P,
              Cladribine Tablets in the CLARITY and                     Vermersch P, Dangond
              CLARITY Extension studies                                 F, Keller B, Jack D        
            A-1026-0033-00521       
            ePoster

    ---                                                                                                                                                                                 ---

             The CLARITY Study: Efficacy Outcomes                      Vermersch P, Rammohan
              Among Patients Who Received Disease-                      K, Damian D, Jack D,
              Modifying Therapies Prior to Treatment                    Harty G, Wong S L
              with Cladribine Tablets                                                              
            A-1026-0031-01868       
            Session Title:
                                                                                                                                  Poster Session 1
                                                                                                                                  Session Date:
                                                                                                                                  09.11.2019
                                                                                                                                  Presenting Time:
                                                                                                                                  5:15-7:15 PM

    ---                                                                                                                                                                                 ---

             Updated safety of cladribine tablets in                   Cook S, Giovannoni G,
              the treatment of patients with                            Leist T, Comi G,
              multiple sclerosis: Integrated safety                     Syed S, Nolting A,
              analysis and post-approval data                           Damian D, Schick R         
            A-1026-0033-00523       
            Session Title:
                                                                                                                                  Poster Session 3
                                                                                                                                  Session Date:
                                                                                                                                  09.13.2019
                                                                                                                                  Presenting Time:
                                                                                                                                  12:15-2:15 PM

    ---                                                                                                                                                                                 ---

             An analysis of the relationship between                   Cook S, Giovannoni G,
              cladribine dose and risk of                               Leist T, Comi G,
              malignancies in patients with multiple                    Nolting A, Sylvester
              sclerosis                                                 E, Jack D, Damian D,
                                                                        Galazka A                  
            A-1026-0033-01927       
            Session Title:
                                                                                                                                  Poster Session 1
                                                                                                                                  Session Date:
                                                                                                                                  09.11.2019
                                                                                                                                  Presenting Time:
                                                                                                                                  5:15-7:15 PM

    ---                                                                                                                                                                                 ---

             Long term, registry-based,                                Butzkueven H,
              prospective, post-authorization                           Korhonen P,
              safety study evaluating adverse events
              of special interest in patients with
              highly active relapsing multiple
              sclerosis newly started on oral
              cladribine - CLARION                                                                 
            A-1026-0033-00518       
            ePoster
                                                               Hillert J, Trojano M,
                                                               Aydemir A,
                                                               Magyari M, Khanfir H,
                                                               Pinuaga C, Sabidó M,
                                                               CLARION Study group

    ---                                                                                                                                                                                 ---

             Incidence of any malignancies in                          Magyari M, Foch C,                                                    Scientific Session 2: Safety assessment in the
              patients treated for multiple                             Nørgaard M, Boutmy                                                    post-approval phase - real world evidence
              sclerosis. A Danish registry-based                        E, Veres K, Sabidó M
              cohort                                                                               
             A-1026-0034-01799
                                                                                                                                  Session Date: 09.11.2019
                                                                                                                                  Presenting Time: 3:01-3:13 PM

    ---                                                                                                                                                                                 ---

             Increase of naïve B cells M2                              Giovannoni G, Leist
              macrophages and reduction of memory B/                    T, Soelberg-
              T cells during immune repopulation at                     Sorensen P,
              96 weeks in CLARITY assessed by Immune                    Kalatskaya I,
              cell deconvolution                                        Boschert U,
                                                                        DeMartino J, Rolfe A       
            A-1026-0031-00511       
            Session Title: Poster Session 2
                                                                                                                                  Session Date: 09.12.2019
                                                                                                                                  Presenting Time: 5:15-7:15 PM

    ---                                                                                                                                                                                 ---

             Long-term effectiveness in patients                       Patti F, Visconti A,
              previously enrolled in the Cladribine                     Capacchione A,
              Tablets pivotal trials: a Real-World                      Trojano M on behalf
              Evidence analysis using data from the                     of the CLARINET-MS
              Italian Multiple Sclerosis Registry                       study group
              (CLARINET-MS)                                                                        
            A-1026-0031-00516       
            Session Title: Poster Session 1
                                                                                                                                  Session Date: 09.11.2019
                                                                                                                                  Presenting Time: 5:15-7:15 PM

    ---                                                                                                                                                                                 ---

             Comparative effectiveness of Cladribine                   Signori A, Saccà F,
              tablets vs other drugs in relapsing-                      Lanzillo R,
              remitting multiple sclerosis: an                          Maniscalco GT,
              approach merging randomized controlled                    Signoriello E,
              trial with real life data                                 Repice A, Annovazzi
                                                                        P, Baroncini D,
                                                                        Clerico M, Binello
                                                                        E, Cerqua R,
                                                                        Mataluni G, Perini
                                                                        P, Bonavita S,
                                                                        Lavorgna L, Zarbo
                                                                        IR, Laroni A,
                                                                        Gutierrez LP, Gioia
                                                                        SL, Frigeni B,
                                                                        Barcella V, Frau J,
                                                                        Cocco E, Fenu G,
                                                                        Clerici VT, Sartori
                                                                        A, Rasia S, Cordioli
                                                                        C, Stromillo ML, Di
                                                                        Sapio A, Pontecorvo
                                                                        S, Grasso R, Barone
                                                                        S, Barrilà C, Russo
                                                                        CV, Esposito S,
                                                                        Ippolito D, Landi D,
                                                                        Visconti A, Sormani
                                                                        MP                         
            A-1026-0031-00187       
            Session Title: Poster Session 2
                                                                                                                                  Session Date: 09.12.2019
                                                                                                                                  Presenting Time: 5:15-7:15 PM

    ---                                                                                                                                                                                 ---

             CD4+ T cells and CD19+ B cells respond                    Carlini F, Ivaldi F,
              differentially to cladribine treatment                    Boschert U, Visconti
              in vitro depending on their activation                    A, de Rosbo NK,
              status. Role of deoxycytidine kinase                      Uccelli A                        
            P1353             
            Session Title: Poster Session 3
                                                                                                                                  Session Date: 09.13.2019
                                                                                                                                  Presenting Time: 12:15-2:15 PM

    ---                                                                                                                                                                                 ---

             Studying the effect of cladribine on                      Eixarch H, Calvo-
              microglia survival, proliferation,                        Barreiro L, Fissolo
              activation and cytokine release                           N, Boschert U,
                                                                        Comabella M,
                                                                        Montalban X, Espejo
                                                                        C                                 
            P610             
            Session Title: Poster Session 1
                                                                                                                                  Session Date: 09.11.2019
                                                                                                                                  Presenting Time: 5:15-7:15 PM

    ---                                                                                                                                                                                 ---

             Effects of 2-chlorodeoxyadenosine                         Aybar F, Perez MJ,
              (Cladribine) on Microglial cells and                      Pasquini JM,
              Astrocytes                                                Correale J                        
            P623             
            Session Title: Poster Session 1
                                                                                                                                  Session Date: 09.11.2019
                                                                                                                                  Presenting Time: 5:15-7:15 PM

    ---                                                                                                                                                                                 ---

             Understanding the mechanisms of action                    C. Rodríguez-Mogeda,
              of Cladribine in innate immune cells                      S. Van der Pol, A.J.
              in MS                                                     Van het Hof, HE. De
                                                                        Vries                             
            P984             
            Session Title: Poster Session 2
                                                                                                                                  Session Date: 09.12.2019
                                                                                                                                  Presenting Time: 5:15-7:15 PM

    ---                                                                                                                                                                                 ---

             Year 1 Performance of adveva(R), a                        Lyons M, Lott N,
              Patient Support Programme for patients                    Morgan K
              taking MAVENCLAD (cladribine tablets)
              in UK                                                                                
            A-1026-0037-01914       
            ePoster

    ---                                                                                                                                                                                 ---

             Cladribine is not mutagenic to                            Järvinen E, Tienari
              mitochondrial DNA and RNA in leukemic                     PJ, Battersby BJ
              cell lines                                                                                  
            P698             
            Session Title: Poster Session 1
                                                                                                                                  Session Date: 09.11.2019
                                                                                                                                  Presenting Time: 5:15-7:15 PM

    ---                                                                                                                                                                                 ---

             Cladribine modify functional properties                   Jørgensen LØ, Hyrlov
              of murine microglia                                       KH, Elkjær ML,
                                                                        Pedersen AE,
                                                                        Svenningsen AF,
                                                                        Illes Z                    
            A-1026-0031-01729       
            Session Title: Poster Session 2
                                                                                                                                  Session Date: 09.12.2019
                                                                                                                                  Presenting Time: 5:15-7:15 PM

    ---                                                                                                                                                                                 ---

             Safety data from the non-                                 Penner, I-K,
              interventional, prospective study                         Ziemssen T, Nolting
              CLEVER (CLadribine Tablets -                              A, Hübschen M,
              EValuation of thERapy satisfaction)                       Richter J, Schel E,
              and CLADQoL (CLADribine Tablets -                         Wagner T, Mueller B,
              evaluation of Quality of Life)                            Posevitz-Fejfar A          
            A-1026-0031-01026       
            Session Title: Poster Session 1
                                                                                                                                  Session Date: 09.11.2019
                                                                                                                                  Presenting Time: 5:15-7:15 PM

    ---                                                                                                                                                                                 ---

             Non-interventional, prospective study                     Ziemssen T, Grothe C,
              CLEVER (CLadribine Tablets -                              Reifschneider G,
              EValuation of thERapy satisfaction)                       Morgenbesser T,
                                                                        Richter J, Schel E,
                                                                        Wagner T, Müller B,
                                                                        Posevitz-Fejfar A          
            A-1026-0031-01164       
            Session Title: Poster Session 1
                                                                                                                                  Session Date: 09.11.2019
                                                                                                                                  Presenting Time: 5:15-7:15 PM

    ---                                                                                                                                                                                 ---

             Non-interventional, prospective study                     Penner, I-K, Raji A,
              CLADQoL (CLADribine Tablets -                             Pul R, Kallmann BA,
              evaluation of Quality of Life)                            Richter J, Schel E,
                                                                        Wagner T, Müller B,
                                                                        Posevitz-Fejfar A          
            A-1026-0031-01120       
            ePoster

    ---                                                                                                                                                                                 ---

             Cladribine tablets versus other                           Bartosik-Psujek H,
              disease-modifying oral treatments in                      Kaczy?ski ?, Górecka
              multiple sclerosis (MS) in achieving                      M, Rolka M, Wójcik
              no evidence of radiological and                           R, Kaczor M P, Zi?ba
              clinical disease activity (NEDA) -                        P
              network meta-analysis (NMA)                                                          
            A-1026-0037-01912       
            Session  Title: Poster Session 2
                                                                                                                                  Session Date: 09.12.2019
                                                                                                                                  Presenting Time: 5:15-7:15 PM

    ---                                                                                                                                                                                 ---

             Cladribine tablets: Observational                         Miravalle A A, Katz
              evaluation of effectiveness, safety,                      J, Sloane J, Hayward
              and patient reported outcomes in                          B, Walsh J S, Harlow
              suboptimally controlled patients                          D E
              previously taking injectable disease-
              modifying drugs for relapsing forms of
              multiple sclerosis (CLICK-MS)                                                        
            A-1026-0033-01906       
            ePoster

    ---                                                                                                                                                                                 ---

             Risk reduction of EDSS progression in                     Thrower B, Fox E J,
              patients with relapsing multiple                          Damian D, Lebson L,
              sclerosis treated with cladribine                         Dangond F
              tablets in the CLARITY study: post-
              hoc analysis including patients who
              went on to receive rescue therapy                                                    
            A-1026-0031-01938       
            Session Title: Poster Session 1
                                                                                                                                  Session Date: 09.11.2019
                                                                                                                                  Presenting Time: 5:15-7:15 PM

    ---                                                                                                                                                                                 ---

             In depth analysis of B cells in                           Marsh-Wakefield F,
              multiple sclerosis patients after                         Juillard P, Ashhurst
              treatment with cladribine                                 T, McGuire H, Byrne
                                                                        SN, Hawke S, Grau GE             
            P1225             
            Session Title: Poster Session 3
                                                                                                                                  Session Date: 09.13.2019
                                                                                                                                  Presenting Time: 12:15-2:15 PM.

    ---                                                                                                                                                                                 ---

             FIMS Study: Exploration of Factors                        Bardsley B, Cinc E,
              which Influence treatment decisions of                    Heriot E, Lazarus K-
              patients with Multiple Sclerosis                          J, McMurtrie M,
                                                                        Haynes J, Coleman E,
                                                                        Macdonell R                       
            P676             
            Session Title: Poster Session 1
                                                                                                                                  Session Date: 09.11.2019
                                                                                                                                  Presenting Time: 5:15-7:15 PM

    ---                                                                                                                                                                                 ---

             Markers of premature immunosenescence                     Clénet ML, Daigneault
              in the peripheral blood of multiple                       A, Laurent C, Jamann
              sclerosis subjects vs. healthy                            H, Mamane V,
              controls                                                  Ouedraogo O, Carmena
                                                                        Moratalla A,
                                                                        Duquette P, Rousseau
                                                                        MC, Arbour N and
                                                                        Larochelle C               
            A-1026-0029-01320       
            Session Title: Poster Session 1
                                                                                                                                  Session Date: 09.11.2019
                                                                                                                                  Presenting Time: 5:15-7:15 PM

    ---                                                                                                                                                                                 ---


            
              MAVENCLAD(R) (cladribine) tablets Late-Breaker Presentation

    ---

             Cladribine decreases CD95 expressing                      Kap Y, Boschert U,
              CD4+ and CD8+ cells in lymphoid organs                    t'Hart B
              in naïve marmosets (Callithrix
              jacchus)                                                                             
            A-1026-0000-02694       
            Session Title: Poster Session 3

                                                                                                                                  
            Session Date: 09.13.2019

                                                                                                                                  
            Presenting Time: 12:15-2:15 PM

    ---                                                                                                                                                                                 ---


            
              Rebif(R) (interferon beta-1a) Presentations

    ---

             Effect of Interferon  -1a Treatment on                    Kuhle J, Leppert D,
              Serum Neurofilament Light Chain Levels                    Comi G, De Stefano
              in Patients with a First Clinical                         N, Kappos L,
              Demyelinating Event in the REFLEX                         Freedman MS, Roy S,
              trial                                                     Issard D                   
            A-1026-0035-00622       
            Session Title: Poster Session 3
                                                                                                                                  Session Date: 09.13.2019
                                                                                                                                  Presenting Time: 12:15-2:15 PM

    ---                                                                                                                                                                                 ---

             Pharmacodynamic biomarkers of                             Freedman MS, Wojcik
              interferon  -1a: Assessment in                            J, D'Antonio M,
              patients receiving long-term                              Hyvert Y, Stinchi S,
              treatment with subcutaneous interferon                    D'Urso V, Dangond F
               -1a in REFLEX and REFLEXION                                                         
             A-1026-0033-00634      
            Session Title: Poster Session 3
                                                                                                                                  Session Date: 09.13.2019
                                                                                                                                  Presenting Time: 12:15-2:15 PM

    ---                                                                                                                                                                                 ---

             Efficacy of subcutaneous interferon                       Freedman MS, Kappos
               -1a in patients with a first clinical                    L, Comi G, De
              demyelinating event: the REbif                            Stefano N, Roy S,
              FLEXible dosing in early multiple                         Issard D
              sclerosis (REFLEX) study - outcomes in
              patients stratified by the 2017
              McDonald criteria                                                                    
            A-1026-0031-00626       
            Session Title: Poster Session 3
                                                                                                                                  Session Date: 09.13.2019
                                                                                                                                  Presenting Time: 12:15-2:15 PM

    ---                                                                                                                                                                                 ---

             Post-hoc Analysis to Evaluate the                         Freedman MS, Brod S,
              Effects of Subcutaneous Interferon  -                     Wray S, Singer B,
              1a in Subgroups of Patients from the                      Dangond F, Issard D,
              PRISMS Study with Early Onset vs Late                     Harlow D, Jack D
              Onset Disease                                                                        
             A-1026-0031-00628      
            ePoster

    ---                                                                                                                                                                                 ---

             Assessing the duration of EDSS                            Signori A, Bovis F,
              improvement after a therapy start: a                      Carmisciano L,
              new statistical approach applied to                       Alexandri N, Sormani
              the long term extension of the PRISMS                     M P
              study                                                                                
            A-1026-0035-00443       
            Session Title: Poster Session 3
                                                                                                                                  Session Date: 09.13.2019
                                                                                                                                  Presenting Time: 12:15-2:15 PM

    ---                                                                                                                                                                                 ---

             Effectiveness of subcutaneous                             Rollot F, Foch C,
              interferon beta-1a 22/44  g versus                        Laplaud D, Boutmy E,
              teriflunomide in newly treated                            Marhardt K, Sabido S
              patients with multiple sclerosis. A
              study in a French nationwide cohort of
              Multiple Sclerosis: Observatoire
              Francais de la sclérose en plaques
              (OFSEP)                                                                              
             A-1026-0034-00636      
            Session Title: Poster Session 2
                                                                                                                                  Session Date: 09.12.2019
                                                                                                                                  Presenting Time: 5:15-7:15 PM

    ---                                                                                                                                                                                 ---

             Prevalence of infant outcomes at birth                    Vattulainen P,
              after exposure to interferon beta                         Burkill S,
              prior to or during pregnancy: A                           Geissbuehler Y,
              register-based cohort study in                            Sabidó M, Popescu C,
              Finland and Sweden among women with MS                    Adamo A, Myhr K-M,
                                                                        Montgomery S,
                                                                        Korhonen P, the
                                                                        European Interferon
                                                                        Beta Pregnancy Study
                                                                        Group and the Nordic
                                                                        MS Pregnancy &
                                                                        Interferon Beta
                                                                        study group                
            A-1026-0009-01725       
            Session Title: Poster Session 3
                                                                                                                                  Session Date: 09.13.2019
                                                                                                                                  Presenting Time: 12:15-2:15 PM

    ---                                                                                                                                                                                 ---

             Systematic mapping of the global                          Bharadia T,
              educational offerings for multiple                        Kesselring J, Boyko
              sclerosis patients on the topic of                        A, Sumelahti M-L on
              disease progression                                       behalf of the MS in
                                                                        the 21st Century
                                                                        initiative, and
                                                                        Alexandri N                
            A-1026-0005-01837       
            Session Title: Poster Session 2
                                                                                                                                  Session Date: 09.12.2019
                                                                                                                                  Presenting Time: 5:15-7:15 PM

    ---                                                                                                                                                                                 ---

             Family planning decisions in people                       Lavorgna L, Worton H,
              with multiple sclerosis                                   S Russell, Jack D          
            A-1026-0009-00639       
            Session Title: Poster Session 3
                                                                                                                                  Session Date: 09.13.2019
                                                                                                                                  Presenting Time: 12:15-2:15 PM

    ---                                                                                                                                                                                 ---


            
              Evobrutinib (Bruton's Tyrosine Kinase Inhibitor) Presentations

    ---

             Bruton's tyrosine kinase (BTK)                            Aigrot M S, Martin E,
              inhibition promotes myelin repair in                      Grenningloh R,
              two different models of demyelination                     Stankoff B, Lubetzki
                                                                        C, Boschert U, Zalc
                                                                        B                          
            A-1026-0025-01553       
            Session Title: Poster Session 3
                                                                                                                                  Session Date: 09.13.2019
                                                                                                                                  Presenting Time: 12:15-2:15 PM

    ---                                                                                                                                                                                 ---

             Inhibition of Bruton's Tyrosine Kinase                    Torke S, Häusler D,
              Selectively Prevents Antigen-                             Grenningloh R,
              Activation of B cells and Ameliorates                     Boschert U, Brück W
              B cell-Mediated Experimental                              and Weber M S
              Autoimmune Encephalomyelitis                                                         
            A-1026-0031-01785       
            Session Title: Poster Session 2
                                                                                                                                  Session Date: 09.12.2019
                                                                                                                                  Presenting Time: 5:15-7:15 PM

    ---                                                                                                                                                                                 ---

             Effect of evobrutinib, a Bruton's                         Montalban X, Shaw J,
              tyrosine kinase inhibitor, on immune                      Syed S, Dangond F,
              cell and immunoglobulin levels over 48                    Martin E C,
              weeks in a phase 2 study in relapsing                     Grenningloh R, Weber
              multiple sclerosis                                        MS, on behalf of the
                                                                        Evobrutinib Phase 2
                                                                        Study Group                
            A-1026-0031-01645       
            Session Title: Poster Session 3
                                                                                                                                  Session Date: 09.13.2019
                                                                                                                                  Presenting Time: 12:15-2:15 PM

    ---                                                                                                                                                                                 ---

About MAVENCLAD(®)

MAVENCLAD, approved by the U.S. Food and Drug Administration (FDA) on March 29, 2019, is the first and only short-course oral therapy for the treatment of adults with relapsing-remitting disease (RRMS) and active secondary progressive disease (SPMS). Because of its safety profile, use of MAVENCLAD is generally recommended for patients who have had an inadequate response to, or are unable to tolerate, an alternate drug indicated for the treatment of multiple sclerosis (MS), and MAVENCLAD is not recommended for use in patients with clinically isolated syndrome (CIS). Patients should follow healthcare provider instructions including cancer screening, contraception and blood tests. The approved dose of MAVENCLAD is 3.5 mg per kg body weight over two years, administered as one treatment course of 1.75 mg per kg per year, each consisting of two treatment weeks. The mechanism by which cladribine exerts its therapeutic effects in patients with multiple sclerosis has not been fully elucidated but is thought to involve cytotoxic effects on B and T lymphocytes through impairment of DNA synthesis, resulting in depletion of lymphocytes. MAVENCLAD causes a dose-dependent reduction in lymphocyte counts followed by recovery.

Because cladribine is cytotoxic, special handling and disposal instructions should be followed.

MAVENCLAD has been approved in over 60 countries, including the European Union (EU), Canada, Australia and Switzerland, for various relapsing MS indications. Visit www.MAVENCLAD.com for more information.

IMPORTANT SAFETY INFORMATION

BOXED WARNING: MALIGNANCIES and RISK OF TERATOGENICITY

    --  Treatment with MAVENCLAD may increase the risk of malignancy. MAVENCLAD
        is contraindicated in patients with current malignancy; evaluate the
        benefits and risks of the use of MAVENCLAD on an individual patient
        basis for patients with prior or increased risk of malignancy.
    --  MAVENCLAD is contraindicated for use in pregnant women and in women and
        men of reproductive potential who do not plan to use effective
        contraception because of the potential for fetal harm.

CONTRAINDICATIONS

    --  Current malignancy.
    --  Pregnancy, and women and men of reproductive potential who do not plan
        to use effective contraception during MAVENCLAD dosing and for 6 m after
        the last dose in each treatment course.
    --  Human immunodeficiency virus (HIV).
    --  Active chronic infections (e.g., hepatitis or tuberculosis).
    --  History of hypersensitivity to cladribine.
    --  Breastfeeding while taking MAVENCLAD and for 10 days after the last
        dose.

DOSING CONSIDERATIONS: After the completion of 2 treatment courses, do not administer additional MAVENCLAD during the next 2 years. The risk of malignancy with reinitiating MAVENCLAD more than 2 years after completion of 2 treatment courses has not been studied.

ADDITIONAL WARNINGS AND PRECAUTIONS

    --  Lymphopenia: In clinical studies, 87% of MAVENCLAD-treated patients
        experienced lymphopenia. Concomitant use of MAVENCLAD with hematotoxic
        drugs may increase the risk of adverse reactions because of the additive
        hematological effects. Monitor lymphocyte counts before and during
        treatment, periodically thereafter, and when clinically indicated.
    --  Infections: Infections occurred in 49% of MAVENCLAD-treated patients
        compared to 44% of patients treated with placebo in clinical studies.
        The most frequent serious infections included herpes zoster and
        pyelonephritis. Single fatal cases of tuberculosis and fulminant
        hepatitis B were reported in the clinical program. Administer
        live-attenuated or live vaccines at least 4 to 6 weeks prior to starting
        MAVENCLAD. Screen patients for latent infections; consider delaying
        treatment until infection is fully controlled. Vaccinate patients
        antibody-negative to varicella zoster virus prior to treatment. Monitor
        for infections.
    --  Hematologic Toxicity: Mild to moderate decreases in neutrophil counts,
        hemoglobin levels, and platelet counts were observed. Severe decreases
        in neutrophil counts were observed in 3.6% of MAVENCLAD-treated
        patients, compared to 2.8% of placebo patients. Obtain complete blood
        count (CBC) with differential including lymphocyte count before and
        during treatment, periodically thereafter, and when clinically
        indicated.
    --  Risk of Graft-versus-Host Disease With Blood Transfusions:  Irradiation
        of cellular blood components is recommended.
    --  Liver Injury:  Obtain liver function tests prior to treatment. 
        Discontinue MAVENCLAD if significant injury is suspected.
    --  Hypersensitivity: In clinical studies, 11% of MAVENCLAD-treated patients
        had hypersensitivity reactions, compared to 7% of placebo patients.
        Serious hypersensitivity reactions occurred in 0.5% of MAVENCLAD-treated
        patients, compared to 0.1% of placebo patients. If a hypersensitivity
        reaction is suspected, discontinue treatment. Do not use MAVENCLAD in
        patients with a history of hypersensitivity to cladribine.

Adverse Reactions: The most common adverse reactions with an incidence of >20% for MAVENCLAD are upper respiratory tract infection, headache, and lymphopenia.

Drug Interactions/Concomitant Medication: Concomitant use of MAVENCLAD with immunosuppressive or myelosuppressive drugs and some immunomodulatory drugs (e.g., interferon beta) is not recommended and may increase the risk of adverse reactions. Avoid concomitant use of certain antiviral and antiretroviral drugs. Avoid concomitant use of BCRP or ENT/CNT inhibitors as they may alter bioavailability of MAVENCLAD.

Please see the full Prescribing Information, including boxed WARNING for additional information.

About Rebif® (interferon beta-1a)
Rebif (interferon beta-1a) is indicated for the treatment of relapsing forms of multiple sclerosis (MS), to include clinically isolated syndrome, relapsing-remitting disease, and active secondary progressive disease, in adults. It is used to decrease the frequency of relapses and delay the occurrence of some of the physical disability that is common in people with MS. The efficacy and safety of Rebif in controlled clinical trials beyond 2-years has not been established.

IMPORTANT SAFETY INFORMATION:
Rebif is contraindicated in patients with a history of hypersensitivity to natural or recombinant interferon beta, human albumin, or any other component of the formulation.

Rebif should be used with caution in patients with depression, a condition that is common in people with multiple sclerosis. Depression, suicidal ideation, and suicide attempts have been reported to occur with increased frequency in patients receiving interferon compounds, including Rebif.

Severe liver injury, including some cases of hepatic failure requiring liver transplantation, has been reported rarely in patients taking Rebif. The potential for liver injury should be considered when used in combination with other products associated with liver injury. Monitor liver function tests and patients for signs and symptoms of hepatic injury. Consider discontinuing Rebif if hepatic injury occurs.

Anaphylaxis and other allergic reactions (some severe) have been reported as a rare complication of Rebif. Discontinue Rebif if anaphylaxis occurs.

In controlled clinical trials, injection site reactions occurred more frequently in Rebif-treated patients than in placebo-treated and Avonex-treated patients. Injection site reactions including injection site pain, erythema, edema, cellulitis, abscess, and necrosis have been reported in the postmarketing setting. Do not administer Rebif into affected area until fully healed; if multiple lesions occur, discontinue Rebif until skin lesions are healed.

Decreased peripheral blood counts in all cell lines, including pancytopenia, have been reported in Rebif-treated patients. In controlled clinical trials, leukopenia occurred at a higher frequency in Rebif-treated patients than in placebo and Avonex-treated patients. Thrombocytopenia and anemia occurred more frequently in 44 mcg Rebif-treated patients than in placebo-treated patients. Patients should be monitored for symptoms or signs of decreased blood counts. Monitoring of complete blood and differential white blood cell counts is also recommended.

Cases of thrombotic microangiopathy (TMA), some fatal, have been reported with interferon beta products, including Rebif, up to several weeks or years after starting therapy. Discontinue Rebif if clinical symptoms and laboratory findings consistent with TMA occur, and manage as clinically indicated.

Caution should be exercised when administering Rebif to patients with pre-existing seizure disorders. Seizures have been temporally associated with the use of beta interferons, including Rebif, in clinical trials and in postmarketing reports.

The most common side effects with Rebif are injection-site disorders, headaches, influenza-like symptoms, abdominal pain, depression, elevated liver enzymes, and hematologic abnormalities.

There are no adequate and well-controlled studies in pregnant women. Rebif should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.

Please see the full Prescribing Information for additional information: http://www.emdserono.com/ms.country.us/en/images/Rebif_PI_tcm115_140051.pdf?Version=

About Evobrutinib
Evobrutinib (M2951) is in clinical development to investigate its potential as a treatment for multiple sclerosis (MS), rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). It is an oral, highly selective inhibitor of Bruton's tyrosine kinase (BTK) which is important in the development and functioning of various immune cells including B lymphocytes and macrophages. Evobrutinib is designed to inhibit primary B cell responses such as proliferation and antibody and cytokine release, without directly affecting T cells. BTK inhibition is thought to suppress autoantibody-producing cells, which preclinical research suggests may be therapeutically useful in certain autoimmune diseases. Evobrutinib is currently under clinical investigation and not approved for any use anywhere in the world.

About Multiple Sclerosis
Multiple sclerosis (MS) is a chronic, inflammatory condition of the central nervous system and is the most common, non-traumatic, disabling neurological disease in young adults. It is estimated that approximately 2.3 million people have MS worldwide. While symptoms can vary, the most common symptoms of MS include blurred vision, numbness or tingling in the limbs and problems with strength and coordination. The relapsing forms of MS are the most common.

EMD Serono, Inc. and Multiple Sclerosis
For more than 20 years, EMD Serono has been relentlessly focused on understanding the journey people living with MS face in order to create a meaningful, positive experience for them and the broader MS community. However, there is still much that is unknown about this complex and unpredictable disease. EMD Serono is digging deeper to advance the science.

About EMD Serono, Inc.
EMD Serono - the biopharmaceutical business of Merck KGaA, Darmstadt, Germany, in the U.S. and Canada - is engaged in the discovery, research and development of medicines for patients with difficult to treat diseases. The business is committed to transforming lives by developing and delivering meaningful solutions that help address the therapeutic and support needs of individual patients. Building on a proven legacy and deep expertise in neurology, fertility and endocrinology, EMD Serono is developing potential new oncology and immuno-oncology medicines while continuing to explore potential therapeutic options for diseases such as psoriasis, lupus and MS. Today, the business has approximately 1,300 employees around the country with commercial, clinical and research operations based in the company's home state of Massachusetts. www.emdserono.com

Your Contact
alice.mcgrail@emdserono.com
Phone: +1 781 738 8791

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