Merck to Present New Data on Mavenclad®, Rebif® and the Investigational Therapy Evobrutinib at the AAN Annual Meeting 2019

Not intended for U.S. or U.K. based media

- 20 abstracts will be presented during the AAN Annual Meeting
2019 to demonstrate Merck's commitment and clinical development
program in multiple sclerosis

Darmstadt, Germany (ots/PRNewswire) - Merck, a leading science and
technology company, today announced that data from across its
multiple sclerosis (MS) portfolio will be presented at the American
Academy of Neurology (AAN) 2019 Annual Meeting, 4-10 May 2019 in
Philadelphia, United States. Merck will present a total of 20
abstracts (18 posters and two platform presentations), including data
on MAVENCLAD® (cladribine tablets), the investigational therapy
evobrutinib (an oral, selective Bruton's Tyrosine Kinase (BTK)
inhibitor) and Rebif® (interferon beta-1a), as well as findings from
the patient perceptions initiative by MS in the 21st Century.

"The wealth of data to be presented at AAN 2019 highlights our
continued progress across our portfolio of marketed products and
investigational agents in multiple sclerosis," said Luciano Rossetti,
Head of Global Research & Development for the Biopharma business of
Merck. "We are very proud of our commitment to further the
understanding of multiple sclerosis and enhance our clinical
development program to meet the needs of patients."

Key MAVENCLAD® data will include:

- Post-hoc analysis of the CLARITY Extension study to examine the
durability of no evidence of disease activity-3 (NEDA-3) in
relapsing MS (RMS) patients receiving cladribine tablets
- Integrated analysis of pooled long-term safety data of cladribine
tablets in patients with MS collated from the CLARITY, CLARITY
Extension, ORACLE-MS studies and the PREMIERE registry
- A new analysis of the speed of onset of the MRI effect is
presented. At 3 months the effect on new inflammatory lesions was
apparent in the ORACLE-MS study. In the same study consistency in
clinical outcomes was observed across different patient subgroups
defined by patient and disease characteristics at baseline
- Abstracts from the ORACLE-MS study describe the effect of
cladribine tablets on early MS
- Results from studies investigating the biological effects of
cladribine tablets, including the effect on lymphocyte
proliferation, and endothelial responsiveness to tumour necrosis
factor and its effect on hematopoietic precursors and immune cells,
to offer further insights on the potential mode of action of
cladribine tablets

Key evobrutinib data will include:

- Results of analysis of the efficacy and safety of evobrutinib in
patients with RMS over 48 Weeks: a randomized, placebo-controlled,
phase 2 study

Key Rebif® data will include:

- Investigation from the European Interferon Beta (IFN?) pregnancy
registry and Nordic health study into the prevalence of pregnancy
outcomes in IFN?-exposed women
- Results from the IMPROVE study on the dynamics of pseudo-atrophy in
RMS patients treated with interferon beta-1a as assessed by monthly
brain MRI

In addition, Merck will be publishing new data from the MS in the
21st Century initiative comparing patient perceptions on MS
management and care across Europe and North America. The initiative,
led by a Steering Group of international MS specialists, aims to gain
insight into patient opinions on unmet needs in MS management.

Merck will also be announcing the launch of a new, collaborative
MS research network called 'MS-LINK' (Leadership and Innovation
Network), an initiative that brings together a community of multiple
sclerosis stakeholders to form a scientific foundation for
sustainable transformation of MS care, with the shared goal of
improving patient outcomes.

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

MAVENCLAD
(cladribine
tablets) data
Title Lead Poster Presentation /
Author Session
Durability of Giovannoni P3.2-100 11:30 - 18:30
NEDA-3 status in G ET, Tuesday 7
patients with May P3: MS
relapsing multiple Clinical Trials
sclerosis receiving and Therapeutic
cladribine tablets: Research
CLARITY Extension
Cladribine tablets Scarberry P3.2-061 11:30 - 18:30
were associated S ET, Tuesday 7
with rapid onset of May P3: MS
improvements in MRI Clinical Trials
outcomes in the and Therapeutic
ORACLE-MS trial Research
The effect of Bowen J P3.2-101 11:30 - 18:30
cladribine tablets ET, Tuesday 7
on delaying the May P3: MS
time to conversion Clinical Trials
to CDMS or McDonald and Therapeutic
MS is consistent Research
across subgroups in
the ORACLE-MS study
Untreated Patients Nørgaard M P4.2-060 11:30 - 18:30
with Multiple ET, Wednesday 8
Sclerosis: May P4: MS
Prevalence and Epidemiology,
Characteristics in Co-Morbidities,
Denmark and in the and Modifiable
United States Risk Factors
Updated safety Cook S P4.2-046 11:30 - 18:30
analysis of ET, Wednesday 8
cladribine tablets May P4: MS
in the treatment of Therapeutics:
patients with MOA and Safety
multiple sclerosis

Gaps in treatment Nicholas J P3.2-102 11:30 - 18:30
and treatment ET, Tuesday 7
discontinuation May P3: MS
among patients with Clinical Trials
multiple sclerosis and Therapeutic
newly-initiating Research
once- or
twice-daily oral
disease-modifying
drugs
Lymphopenia rates Cook S P3.2-062 11:30 - 18:30
in CLARITY/CLARITY ET, Tuesday 7
Extension are May P3: MS
consistent in Clinical Trials
patients with or and Therapeutic
without high Research
disease activity at
baseline

Meta-analysis of Nicholas J P3.2-041 11:30 - 18:30
real-world ET, Tuesday 7
adherence and May P3: MS
persistence of Clinical Trials
maintenance once- and Therapeutic
or twice-daily oral Research
disease-modifying
drugs (dimethyl
fumarate,
fingolimod, and
teriflunomide) in
multiple sclerosis

ADA genetic Stampanoni P4.2-044 11:30 - 18:30
variants influence Bassi M ET, Wednesday 8
central May P4: MS
inflammation and Therapeutics:
clinical MOA and Safety
characteristics in
MS: implications
for cladribine
treatment
Dissection of the Carlini F P4.2-045 11:30 - 18:30
distinct ET, Wednesday 8
susceptibility of May P4: MS
hematopoietic Therapeutics:
precursors and MOA and Safety
immune cells to
cladribine

Neuroblastoma cell Ruggieri M P2.2-095 11:30 - 18:30
line and ET, Monday 6
lymphocytes talk May P2: MS
for cladribine Immunology and
influenced Basic Science
apoptosis and
inflammation
pathways in
Multiple Sclerosis
(MS): an "in vitro"
study
Gene expression Mechelli R P2.2-096 11:30 - 18:30
profiles of ET, Monday 6
proteins involved May P2: MS
in cladribine Immunology and
metabolism and Basic Science
their possible
correlation with
Epstein-Barr virus
variants
Evobrutinib data
Efficacy and Safety Montalban Oral 13:33 ET,
of the Bruton's X presentation Friday 10 May
Tyrosine Kinase S56: MS Trials
Inhibitor and Treatment
Evobrutinib (M2951)
in Patients with
Relapsing Multiple
Sclerosis over 48
Weeks: a
Randomized,
Placebo-Controlled,
Phase 2 Study
Inhibition of Alankus YB P2.2-077 11:30 - 18:30
Bruton's Tyrosine ET, Monday 6
Kinase Prevents May P2: MS
Inflammatory Immunology and
Macrophage Basic Science
Differentiation: A
Potential Role in
Multiple Sclerosis
Inhibition of Torke S P2.2-063 11:30 - 18:30
Bruton's Tyrosine ET, Monday 6
Kinase Selectively May P2: MS
Prevents Immunology and
Antigen-Activation Basic Science
of B cells and
Ameliorates
B-Cell-Mediated
Experimental
Autoimmune
Encephalomyelitis
Rebif® (interferon
beta-1a)
Pregnancy and Hellwig K 450 13:44 ET,
Infant Outcomes Thursday 9
with Interferon MayS49: MS
Beta: Data from the Epidemiology
European Interferon and Risk
Beta Pregnancy Stratification
Registry and MS
Preg study
conducted in
Finland and Sweden
Dynamics of De Stefano P5.2-047 11:30 - 18:30
Pseudo-Atrophy in N ET, Thursday 9
RRMS Patients May P5: MS
Treated with Neuroimaging
Interferon beta-1a
as Assessed by
Monthly Brain MRI

MS in the 21st
Century
Comparing patient Williams M P4.9-076 11:30 - 18:30
perceptions on ET, Wednesday 8
multiple sclerosis May P4:
management and care Practice,
- a sub-analysis of Policy, and
geographic Ethics I
differences

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About MAVENCLAD®

MAVENCLAD® is a short-course oral therapy that selectively and
periodically targets lymphocytes thought to be integral to the
pathological process of relapsing MS (RMS). In August 2017, the
European Commission (EC) granted marketing authorization for
MAVENCLAD® for the treatment of relapsing forms of multiple sclerosis
(RMS) in the 28 countries of the European Union (EU) in addition to
Norway, Liechtenstein and Iceland. MAVENCLAD® has since then been
approved in more than 50 countries, including Canada and Australia
and most recently in the U.S. in March 2019.

Visit www.MAVENCLAD.com for more information.

The clinical development program for cladribine tablets includes:

- The CLARITY (Cladribine Tablets Treating MS Orally) study: a
two-year Phase III placebo-controlled study designed to evaluate
the efficacy and safety of cladribine tablets as a monotherapy in
patients with RRMS.
- The CLARITY extension study: a Phase III placebo-controlled study
following on from the CLARITY study, which evaluated the safety and
exploratory efficacy of cladribine tablets over two additional
years beyond the two-year CLARITY study, according to the treatment
assignment scheme for years 3 and 4.
- The ORACLE MS (Oral Cladribine in Early MS) study: a two-year Phase
III placebo-controlled study designed to evaluate the efficacy and
safety of cladribine tablets as a monotherapy in patients at risk
of developing MS (patients who have experienced a first clinical
event suggestive of MS).
- The ONWARD (Oral Cladribine Added ON to Interferon beta-1a in
Patients With Active Relapsing Disease) study: a Phase II
placebo-controlled study designed primarily to evaluate the safety
and tolerability of adding cladribine tablets treatment to patients
with relapsing forms of MS, who have experienced breakthrough
disease while on established interferon-beta therapy.
- PREMIERE (Prospective Observational Long-term Safety Registry of
Multiple Sclerosis) study: a long-term observational follow-up
safety registry of MS patients who participated in cladribine
tablets clinical studies.

In the two-year CLARITY study, the most commonly reported adverse
event (AE) in patients treated with cladribine tablets was
lymphopenia (26.7% with cladribine tablets and 1.8% for placebo). The
incidence of infections was 48.3% with cladribine tablets and 42.5%
with placebo, with 99.1% and 99.0% respectively rated
mild-to-moderate by investigators. Adverse Events reported in other
clinical studies were similar.

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 specific 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 Rebif®

Rebif® (interferon beta-1a) is a disease-modifying drug used to
treat relapsing forms of multiple sclerosis (MS) and is similar to
the interferon beta protein produced by the human body. The efficacy
of Rebif® in chronic progressive MS has not been established.
Interferon ß is thought to help reduce inflammation. The exact
mechanism is unknown.

Rebif®, which was approved in Europe in 1998 and in the US in
2002, is registered in more than 90 countries worldwide. Rebif® has
been proven to delay the progression of disability, reduce the
frequency of relapses and reduce MRI lesion activity and area*.

Rebif® can be administrated with the RebiSmart® electronic
auto-injection device (not approved in the US), or with the RebiDose®
single-use disposable pen, or the manual multidose injection pen
RebiSlide(TM). Rebif® can also be administered with the autoinjector
Rebiject II® or by manual injection using ready-to-use pre-filled
syringes. These injection devices are not approved in all countries.

In January 2012, the European commission approved the extension of
the indication of Rebif® in early multiple sclerosis. The extension
of the indication of Rebif® has not been submitted in the United
States.

Rebif® should be used with caution in patients with a history of
depression, liver disease, thyroid abnormalities and seizures. Most
commonly reported side effects are flu-like symptoms, injection site
disorders, elevation of liver enzymes and blood cell abnormalities.
Patients, especially those with depression, seizure disorders, or
liver problems, should discuss treatment with Rebif® with their
doctors.

*The exact correlation between MRI findings and the current or
future clinical status of patients, including disability progression,
is unknown.

Rebif® (interferon beta-1a) is approved in the United States for
relapsing forms of MS.

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.

Merck in Immunology

Merck has a long-standing legacy in immunology, with significant
R&D and commercial experience in multiple sclerosis. Our robust
immunology pipeline focuses on discovering new therapies that have
the potential to modulate key pathogenic mechanisms in chronic
diseases such as MS, systemic lupus erythematosus (SLE) and forms of
arthritis, including rheumatoid arthritis (RA) and osteoarthritis
(OA).

About Merck

Merck, a leading science and technology company, operates across
healthcare, life science and performance materials. Around 52,000
employees work to make a positive difference to millions of people's
lives every day by creating more joyful and sustainable ways to live.
From advancing gene editing technologies and discovering unique ways
to treat the most challenging diseases to enabling the intelligence
of devices - the company is everywhere. In 2018, Merck generated
sales of EUR 14.8 billion in 66 countries.

Scientific exploration and responsible entrepreneurship have been
key to Merck's technological and scientific advances. This is how
Merck has thrived since its founding in 1668. The founding family
remains the majority owner of the publicly listed company. Merck
holds the global rights to the Merck name and brand. The only
exceptions are the United States and Canada, where the business
sectors of Merck operate as EMD Serono in healthcare, MilliporeSigma
in life science, and EMD Performance Materials.

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