Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease (MOGAD)Phase 3SMARTNCT07917247
Safety and Efficacy of Secukinumab Versus Mycophenolate Mofetil in Relapsing Myelin Oligodendrocyte Glycoprotein Antibody-associated Disease (SMART)
A Phase 3 study testing Secukinumab and Mycophenolate mofetil (MMF) in people with Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease (MOGAD), run by Chinese PLA General Hospital.
Trial summary
The goal of this clinical trial is to evaluate the safety and efficacy of secukinumab versus mycophenolate mofetil in relapsing myelin oligodendrocyte glycoprotein antibody-associated disease. Read more about this study
- Who is it for?
- Ages 6 years and older
- Conditions the study is for
- Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease (MOGAD)
- What is being tested?
- Secukinumab and Mycophenolate mofetil (MMF)
- Type of treatment
- Pill or oral medicine, Injection or infusion
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 130 participants
- Where
- No sites listed yet
- Study dates
- 15 Nov 2026to 15 Nov 2028
- Phase
- Phase 3
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 6 years and older
- All sexes
- No healthy volunteers
- Child, Adult, Older adult
Who may be able to join
- Participants must meet all of the following conditions in order to be enrolled:
- Participants who are aged ≥12 years at the time of signing Informed Consent Form;
- Confirmed diagnosis of MOGAD with a history of ≥1 MOGAD relapse in the 12 months prior to screening or ≥2 attacks in the 24 months prior to screening;
- Anti-MOG antibody clear seropositive using Live cell-based assay (Live CBA);
- Expanded Disability Status Scale (EDSS) ≤7.5
- For women of childbearing potential: participants who agree to remain abstinent or use adequate contraception during the treatment period and for at least 3 months after the final dose of the experimental drugs;
- Patients must give written informed consent.
Who cannot join
- Age<6 years old;
- Participants who are pregnant or breastfeeding, or intending to become pregnant during the study or within 3 months after the final dose of the experimental drugs;
- Individuals who are allergic to any component of the experimental drug;
- Previous exposure to secukinumab or other biologic drug directly targeting IL-17 or IL-17 receptor;
- Treatment with tocilizumab, other IL-6/IL6-R inhibitor or JAK inhibitor within 12
- weeks or within 5 half-lives of the drug (whichever is longer) prior to Baseline;
Show all 18Show fewer
- Receipt of rituximab or any experimental B-cell depleting agent within 6 months prior screening and B-cells below the lower limit of normal;
- Receipt of intravenous immunoglobulin (IVIG) or plasma exchange (PE) within 8 weeks prior to randomization;
- Receipt of any of the following within 3 months prior to randomization: Natalizumab (Tysabri®), Methotrexate Mitoxantrone Cyclophosphamide, Eculizumab, Ofacizumab, Satolizumab, or interferon, pegylated interferon, and glatiramer acetate;
- Patients treated with cyclophosphamide, tacrolimus, everolimus, hydroxychloroquine, cyclosporine A, azathioprine, sulfasalazine within 6 months prior to Baseline;
- Patients treated with leflunomide within 8 weeks of Baseline unless a cholestyramine washout has been performed in which case the patient must be treated within 4 weeks of Baseline;
- Any other biologics within 4 weeks or within 5 half-lives of the drug (whichever is longer) prior to Baseline;
- Active ongoing diseases which in the opinion of the investigator immunocompromises the patient and/or places the patient at unacceptable risk for treatment with immunomodulatory therapy;
- (8) Hepatitis B surface antigen (HBsAg) positive, or hepatitis B core antibody (HBcAb) positive and peripheral blood HBV DNA positive; Individuals with positive hepatitis C virus (HCV) antibodies and positive HCV RNA; Positive for Treponema pallidum antibody; HIV antibody positive; Cytomegalovirus (CMV) DNA positive individuals;
- History of ongoing, chronic or recurrent infectious disease or evidence of tuberculosis infection as defined by a positive QuantiFERON TB- Gold Plus test. Patients with a positive test may participate in the study if further work up (according to local practice/guidelines) establishes conclusively that the patient has no evidence of active tuberculosis. If presence of latent tuberculosis is established then treatment according to local country guidelines must be initiated prior to randomization.
- Live vaccinations within 6 weeks prior to Baseline or planned vaccination during study participation until 12 weeks after last study treatment administration.
- Other researchers have determined laboratory test results that are clinically significant and believe that the patient is not suitable to participate in this clinical trial.
- Researchers believe that participants in this clinical trial are not suitable for other reasons.
Trial locations and contacts
No sites are listed yet. Contact the study team or a site near you to ask about taking part.
About this study
Official title: Safety and Efficacy of Secukinumab Versus Mycophenolate Mofetil in Relapsing Myelin Oligodendrocyte Glycoprotein Antibody-associated Disease (SMART): a Multicenter, Prospective, Randomized, Controlled, Open-label, Blinded-endpoint Phase 3 Trial
The goal of this clinical trial is to evaluate the safety and efficacy of secukinumab versus mycophenolate mofetil in relapsing myelin oligodendrocyte glycoprotein antibody-associated disease.
Read the detailed description
Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) is an inflammatory demyelinating disease of the central nervous system mediated primarily by antibodies against myelin oligodendrocyte glycoprotein (MOG-IgG). Its clinical manifestations include optic neuritis (ON), acute transverse myelitis (ATM), acute disseminated encephalomyelitis (ADEM), and, more rarely, various forms of encephalitis. Data from several cohorts suggest that approximately 50% of adult patients with MOG-IgG relapse within the first two years of disease onset. No drug is currently approved by the FDA for MOGAD, and mycophenolate mofetil (MMF) is widely used as a conventional first-line maintenance immunosuppressant. Interleukin-17A (IL-17A), a key cytokine secreted by T helper 17 (Th17) cells, participates in downstream inflammatory responses, promotes Th17 cell differentiation through a positive feedback loop, and drives the differentiation of B cells into antibody-producing plasma cells. Studies have shown that peripheral blood Th17 cell levels are significantly higher in MOGAD patients, in both the acute and remission phases, than healthy controls. Patients with higher peripheral Th17 cell counts tend to have more severe disease and higher relapse rates, suggesting that IL-17A may contribute to the pathogenesis and progression of MOGAD. Secukinumab, a humanized monoclonal antibody against the IL-17A has shown beneficial clinical effects and reduction of the risk of relapses in some patients with relapsing MOGAD in our previous pilot study. However, the efficacy and safety of secukinumab in relapsing MOGAD warrants further clinical trials.
- Being tested
- Secukinumab, Mycophenolate mofetil (MMF)
- Medical subject headings
- Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
SecukinumabDrug
Secukinumab 300 mg s.c. (2 x 1 mL pre-filled syringe (PFS) 150 mg secukinumab) at Baseline, Weeks 1, 2, 3, followed by administration every four weeks starting at Week 4. Secukinumab will be given in combination with a protocol-specified prednisone taper regimen.
Mycophenolate mofetil (MMF)Drug
Mycophenolate mofetil (MMF) 1000 mg p.o. twice daily (Pediatric dose: 500-750 mg/m² body surface area, administered orally in two divided doses). MMF will be given in combination with a protocol-specified prednisone taper regimen.
| Study group | Role | What they receive |
|---|---|---|
| secukinumab | Experimental | Secukinumab 300 mg s.c. (2 x 1 mL pre-filled syringe (PFS) 150 mg secukinumab) at Baseline, Weeks 1, 2, 3, followed by administration every four weeks starting at Week 4. Secukinumab will be given in combination with a protocol-specified prednisone taper regimen. Receives: Drug: Secukinumab |
| mycophenolate mofetil | Active comparator | Mycophenolate mofetil (MMF) 1000 mg p.o. twice daily (Pediatric dose: 500-750 mg/m² body surface area, administered orally in two divided doses). MMF will be given in combination with a protocol-specified prednisone taper regimen. Receives: Drug: Mycophenolate mofetil (MMF) |
What is being measured
The primary outcome is the main question the study is designed to answer.
the time to first adjudicated relapse from randomization
An adjudicated relapse was defined by the protocol and positively adjudicated by the independent adjudication committee.
Measured: Baseline, Up To 48 Weeks or End of Study
Secondary outcomes (6)
Annualized relapse rate during any exposure to the experimental drugs
The adjudicated annualized relapse rate (ARR) was defined as the total number of protocoldefined relapses divided by the corresponding observation period in years. Before randomization, ARR was calculated as the total number of relapses before randomization divided by the time from first relapse to randomization (in days) and then divided by 365 for patients with a disease duration of ≤2 years, or as the number of relapses within the 2 years before randomization divided by 2 for patients with a disease duration of >2 years.
Measured: Baseline, Up To 48 Weeks or End of Study
Relapse-free and steroid-free remission state at EOS visit
Relapse-free and steroid-free remission state at EOS visit
Measured: 48 Weeks or End of Study
Change from baseline in dosage of prednisone at EOS visit
Change from baseline in dosage of prednisone at EOS visit
Measured: Baseline, Up To 48 Weeks or End of Study
Change from baseline in EDSS score at EOS visit
Disease-related disability was measured by the EDSS. The EDSS was an ordinal clinical rating scale that ranges from 0 (normal neurologic examination) to 10 (death) in half-point increments. A decrease in score indicates improvement
Measured: Baseline, Up To 48 Weeks or End of Study
Change from baseline in active MRI lesions at EOS visit
active MRI lesions: new Gd-enhancing lesions
Measured: Baseline, Up To 48 Weeks or End of Study
Treatment-emergent adverse events (TEAEs), including treatment-emergent serious adverse events (TESAEs)
An AE was any untoward medical occurrence in a participant who received study drug without regard to possibility of causal relationship A SAE was any AE that resulted in death, life threatening, inpatient hospitalization or prolongation of existing hospitalization
Measured: Baseline, Up To 48 Weeks or End of Study
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted4 Nov 2026
- Study start15 Nov 2026 (estimated)
- Primary completion15 May 2028 (estimated)
- Study completion15 Nov 2028 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease (MOGAD)Studies of the same condition, open and under way.
- More trials run by Chinese PLA General HospitalThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 3
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind
- Who is masked
- Outcomes assessor
- Enrolment
- 130 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Chinese PLA General Hospital
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Huanfen Zhou, Chinese PLA General Hospital
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07917247
- Sponsor's protocol ID
- S2026-758-01
- Acronym
- SMART
- Status last verified
- Oct 2026
- First submitted
- 29 Oct 2026
- Last updated
- 4 Nov 2026
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Banwell B, Bennett JL, Marignier R, Kim HJ, Brilot F, Flanagan EP, Ramanathan S, Waters P, Tenembaum S, Graves JS, Chitnis T, Brandt AU, Hemingway C, Neuteboom R, Pandit L, Reindl M, Saiz A, Sato DK, Rostasy K, Paul F, Pittock SJ, Fujihara K, Palace J. Diagnosis of myelin oligodendrocyte glycoprotein antibody-associated disease: International MOGAD Panel proposed criteria. Lancet Neurol. 2023 Mar;22(3):268-282. doi: 10.1016/S1474-4422(22)00431-8. Epub 2023 Jan 24.
PubMed 36706773
Study at a glance
From the registry record, last updated by the sponsor on 4 Nov 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Safety and Efficacy of Secukinumab Versus Mycophenolate Mofetil in Relapsing Myelin Oligodendrocyte Glycoprotein Antibody-associated Disease (SMART): a Multicenter, Prospective, Randomized, Controlled, Open-label, Blinded-endpoint Phase 3 Trial
- ClinicalTrials.gov ID
- NCT07917247
- Acronym / sponsor ID
- SMART / S2026-758-01
- Phase
- Phase 3
- Study type
- Interventional
- Recruitment status
- Not yet recruiting
- Enrolment
- 130 participants (estimated)
- Lead sponsor
- Chinese PLA General HospitalUniversity, hospital or other
- Study start
- 15 Nov 2026 (estimated)
- Primary completion
- 15 May 2028 (estimated)
- Study completion
- 15 Nov 2028 (estimated)
- First posted
- 4 Nov 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The goal of this clinical trial is to evaluate the safety and efficacy of secukinumab versus mycophenolate mofetil in relapsing myelin oligodendrocyte glycoprotein antibody-associated disease.
Detailed description
Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) is an inflammatory demyelinating disease of the central nervous system mediated primarily by antibodies against myelin oligodendrocyte glycoprotein (MOG-IgG). Its clinical manifestations include optic neuritis (ON), acute transverse myelitis (ATM), acute disseminated encephalomyelitis (ADEM), and, more rarely, various forms of encephalitis. Data from several cohorts suggest that approximately 50% of adult patients with MOG-IgG relapse within the first two years of disease onset. No drug is currently approved by the FDA for MOGAD, and mycophenolate mofetil (MMF) is widely used as a conventional first-line maintenance immunosuppressant. Interleukin-17A (IL-17A), a key cytokine secreted by T helper 17 (Th17) cells, participates in downstream inflammatory responses, promotes Th17 cell differentiation through a positive feedback loop, and drives the differentiation of B cells into antibody-producing plasma cells. Studies have shown that peripheral blood Th17 cell levels are significantly higher in MOGAD patients, in both the acute and remission phases, than healthy controls. Patients with higher peripheral Th17 cell counts tend to have more severe disease and higher relapse rates, suggesting that IL-17A may contribute to the pathogenesis and progression of MOGAD. Secukinumab, a humanized monoclonal antibody against the IL-17A has shown beneficial clinical effects and reduction of the risk of relapses in some patients with relapsing MOGAD in our previous pilot study. However, the efficacy and safety of secukinumab in relapsing MOGAD warrants further clinical trials.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| secukinumab | Experimental | Drug: SecukinumabSecukinumab 300 mg s.c. (2 x 1 mL pre-filled syringe (PFS) 150 mg secukinumab) at Baseline, Weeks 1, 2, 3, followed by administration every four weeks starting at Week 4. Secukinumab will be given in combination with a protocol-specified prednisone taper regimen. |
| mycophenolate mofetil | Active comparator | Drug: Mycophenolate mofetil (MMF)Mycophenolate mofetil (MMF) 1000 mg p.o. twice daily (Pediatric dose: 500-750 mg/m² body surface area, administered orally in two divided doses). MMF will be given in combination with a protocol-specified prednisone taper regimen. |
Who may qualify
- Ages
- 6 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Child, Adult, Older adult
Key inclusion criteria (7 listed)
- Participants who are aged ≥12 years at the time of signing Informed Consent Form;
- Confirmed diagnosis of MOGAD with a history of ≥1 MOGAD relapse in the 12 months prior to screening or ≥2 attacks in the 24 months prior to screening;
- Anti-MOG antibody clear seropositive using Live cell-based assay (Live CBA);
- Expanded Disability Status Scale (EDSS) ≤7.5
- For women of childbearing potential: participants who agree to remain abstinent or use adequate contraception during the treatment period and for at least 3 months after the final dose of the experimental drugs;
Key exclusion criteria (18 listed)
- Age<6 years old;
- Participants who are pregnant or breastfeeding, or intending to become pregnant during the study or within 3 months after the final dose of the experimental drugs;
- Individuals who are allergic to any component of the experimental drug;
- Previous exposure to secukinumab or other biologic drug directly targeting IL-17 or IL-17 receptor;
- Treatment with tocilizumab, other IL-6/IL6-R inhibitor or JAK inhibitor within 12
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| SecukinumabSecukinumab 300 mg s.c. (2 x 1 mL pre-filled syringe (PFS) 150 mg secukinumab) at Baseline, Weeks 1, 2, 3, followed by administration every four weeks starting at Week 4. Secukinumab will be given in combination with a protocol-specified prednisone taper regimen. | Drug | secukinumab |
| Mycophenolate mofetil (MMF)Mycophenolate mofetil (MMF) 1000 mg p.o. twice daily (Pediatric dose: 500-750 mg/m² body surface area, administered orally in two divided doses). MMF will be given in combination with a protocol-specified prednisone taper regimen. | Drug | mycophenolate mofetil |
Primary outcome
the time to first adjudicated relapse from randomization
Time frame: Baseline, Up To 48 Weeks or End of Study
An adjudicated relapse was defined by the protocol and positively adjudicated by the independent adjudication committee.
6 secondary outcomes
Annualized relapse rate during any exposure to the experimental drugs
Time frame: Baseline, Up To 48 Weeks or End of Study
Relapse-free and steroid-free remission state at EOS visit
Time frame: 48 Weeks or End of Study
Change from baseline in dosage of prednisone at EOS visit
Time frame: Baseline, Up To 48 Weeks or End of Study
Change from baseline in EDSS score at EOS visit
Time frame: Baseline, Up To 48 Weeks or End of Study
Change from baseline in active MRI lesions at EOS visit
Time frame: Baseline, Up To 48 Weeks or End of Study
Treatment-emergent adverse events (TEAEs), including treatment-emergent serious adverse events (TESAEs)
Time frame: Baseline, Up To 48 Weeks or End of Study
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 4 Nov 2026.
- Background: PubMed 36706773Banwell B, Bennett JL, Marignier R, Kim HJ, Brilot F, Flanagan EP, Ramanathan S, Waters P, Tenembaum S, Graves JS, Chitnis T, Brandt AU, Hemingway C, Neuteboom R, Pandit L, Reindl M, Saiz A, Sato DK, Rostasy K, Paul F, Pittock SJ, Fujihara K, Palace J. Diagnosis of myelin oligodendrocyte glycoprotein antibody-associated disease: International MOGAD Panel proposed criteria. Lancet Neurol. 2023 Mar;22(3):268-282. doi: 10.1016/S1474-4422(22)00431-8. Epub 2023 Jan 24.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
Questions about this trial
What is this clinical trial studying?
A Phase 3 study testing Secukinumab and Mycophenolate mofetil (MMF) in people with Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease (MOGAD), run by Chinese PLA General Hospital.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 7 inclusion and 18 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: opening soon, as of the sponsor's last update on 4 Nov 2026. Status can change between updates, so confirm with the study contact before making plans.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Huanfen Zhou, M.D. (+86 01066938024, zhouzhoueye@163.com), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
the time to first adjudicated relapse from randomization (time frame: Baseline, Up To 48 Weeks or End of Study). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT07917247, which also lists 1 linked publication.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 4 Nov 2026; AzTrials last refreshed its copy on 8 Nov 2026.