Evidence map›Paper›PMID 41697690›Full record

Trial reportJAMA neurology2026

Five Years of Ublituximab in Multiple Sclerosis: ULTIMATE I and II Open-Label Extension Study.

Bruce A C Cree, Edward Fox, Hans-Peter Hartung, Enrique Alvarez, Peiqing Qian, Sibyl Wray, Derrick Robertson, Krzysztof Selmaj, Daniel Wynn, Koby Mok and 5 more

Registry-linked trialAbstract readRandomized Controlled TrialMulticenter StudyClinical Trial, Phase II
In one paragraph

Trial report in JAMA neurology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04130997 (An Open Label Extension Study of Ublituximab in Subjects With Relapsing Multiple Sclerosis), which is not on this map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04130997 phase3active not recruitingnot on this map

An Open Label Extension Study of Ublituximab in Subjects With Relapsing Multiple Sclerosis

TypeinterventionalSponsorTG Therapeutics, Inc.Ran2019 to 2032Enrolled1,100ConditionsRelapsing Multiple Sclerosis (RMS)ArmsUblituximab
3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Trial
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Bruce A C CreeWeill Institute for Neurosciences, Department of Neurology, University of California, San Francisco.
Edward FoxTG Therapeutics, Morrisville, North Carolina.
Hans-Peter HartungHeinrich Heine University Medical School, Düsseldorf, Germany.
Enrique AlvarezUniversity of Colorado, Aurora.
Peiqing QianSwedish Medical Center, Seattle, Washington.
Sibyl WrayHope Neurology, Knoxville, Tennessee.
Derrick RobertsonUniversity of South Florida, Tampa.
Krzysztof SelmajDepartment of Neurology, University of Warmia and Mazury, Olsztyn, and Center of Neurology, Lodz, Poland.
Daniel WynnConsultants in Neurology, Northbrook, Illinois.
Koby MokTG Therapeutics, Morrisville, North Carolina.
Chris RowlandTG Therapeutics, Morrisville, North Carolina.
Karthik BodhinathanTG Therapeutics, Morrisville, North Carolina.
Peter SportelliTG Therapeutics, Morrisville, North Carolina.
Hari P MiskinTG Therapeutics, Morrisville, North Carolina.
Lawrence SteinmanBeckman Center for Molecular Medicine, Stanford University, Stanford, California.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Importance: In the 2-year Study to Assess the Efficacy and Safety of Ublituximab in Participants With Relapsing Forms of Multiple Sclerosis (ULTIMATE) I and II randomized clinical studies, disease activity was significantly reduced with ublituximab vs teriflunomide in participants with relapsing multiple sclerosis (RMS). Objective: To evaluate long-term ublituximab clinical efficacy and safety. Design, Setting, and Participants: The 2-year, multicenter, randomized, active-controlled, double-blind period (DBP) of the ULTIMATE I and II phase 3 studies occurred September 2017 to November 2020. Enrollment in the ongoing ULTIMATE open-label extension (OLE) study began November 2019; data cutoff for this analysis was January 1, 2024. Intervention: ULTIMATE OLE participants continued ublituximab (UBL-UBL) or switched from teriflunomide to ublituximab (TER-UBL). Main Outcomes and Measures: Efficacy (annualized relapse rate [ARR], 24-week confirmed disability progression [CDP24], and 24-week confirmed disability improvement [CDI24]) and safety were key outcomes. Results: Of 985 adults with RMS who completed ULTIMATE I and II, 851 enrolled in the ULTIMATE OLE and were included in the analysis. On DBP completion, more than 85% of participants (UBL-UBL, 422 of 494; TER-UBL, 429 of 491) entered the OLE, of whom more than 70% (UBL-UBL, 297 of 422; TER-UBL, 327 of 429) continued taking ublituximab at year 5 (OLE year 3) at data cutoff, making up the analysis population (mean [SD] age, 38.5 [9.7] years; 532 female [62.5%]). TER-UBL participants experienced a 58.4% ARR reduction at 1 year after the switch (0.182 vs 0.076; rate ratio, 0.42; 95% CI, 0.29-0.60; P < .001), and ARR continued to decrease to 0.048 (year 4) and 0.045 (year 5). UBL-UBL participants had further ARR reductions after the DBP (0.053, 0.032, and 0.020 for years 3, 4, and 5, respectively). At year 5, CDP24 was 8.0% in UBL-UBL participants vs 14.3% in TER-UBL participants (P = .01), and CDI24 was 17.0% in UBL-UBL participants vs 12.2% in TER-UBL participants (P = .02). Adverse events were consistent with the established safety profile from pivotal trials, with exposure-adjusted incidence rates per 100 participant-years of serious infections (excluding COVID events) of 2.10 (UBL-UBL) and 2.58 (TER-UBL). On average, immunoglobulin levels remained above the lower limit of normal, and no significant differences in serious infection rates were observed regardless of immunoglobulin level. Conclusions and Relevance: Results reveal that sustained clinical benefits were observed with 5 years of ublituximab treatment: ARR in year 5 showed 1 relapse per 50 participant-years of ublituximab treatment and 92% of UBL-UBL participants remained free from CDP24. Results confirm long-term ublituximab benefits and early initiation of high-efficacy treatment. Trial Registration: ClinicalTrials.gov Identifier: NCT04130997.

Indexed as

Multiple Sclerosis, Relapsing-RemittingAdultCrotonatesDouble-Blind MethodFemaleHumansHydroxybutyratesMaleMiddle AgedNitrilesToluidinesTreatment OutcomeCrotonatesHydroxybutyratesNitrilesteriflunomideToluidines

Identifiers

PMID41697690
PMCPMC12910456

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.