Study Assessing Safety and Therapeutic Activity of AFFITOPE® PD01A and PD03A in Patients With Early MSA

Inclusion Criteria: * Possible or probably MSA diagnosis (MSA-P or MSA-C) according to Gilman 2008 consensus criteria * Onset of MSA symptoms less than 4 years * Participants with an anticipated survival of at least 3 years in the opinion of the PI * Written informed consent obtained prior to study entry * MSA patient \> 30 and \< 75 years of age at time of study entry * Female patients of childbearing potential using a medically accepted contraceptive method * Stable medication for MSA symptoms (Levodopa, Dopamine agonists, Midodrine, Fludrocortisone, monoamine oxidase-B and Catechol-O-methyltransferase inhibitors; Antidepressants, Laxatives, NSAIDs or paracetamol as basic medication for pain in the musculoskeletal system) Exclusion Criteria: * Pregnant or lactating women * Sexually active women of childbearing potential not using a medically accepted birth control method * Patients with dementia (MOCA at Screening \< 21) * Speech impairment as assessed by a score of ≥ 3 on UMSARS question 1 * Swallowing impairment as assessed by a score of ≥ 3 on UMSARS question 2 * Impairment in ambulation as assessed by a score of ≥ 3 on UMSARS question 7 * History or evidence of any other central nervous system disorder like stroke, angioma and other relevant neurological diseases * History of malignancy other than skin cancer during the last 5 years (if considered to be cured, patient might be included) * Active or passive vaccination 4 weeks before the first vaccination on Day 0 and during the main study period ending on Day 280. Emergency vaccinations are acceptable * Use of any other investigational or non-registered drug or vaccine in addition to the study vaccine during the entire study period * Subjects participating or have participated in another interventional clinical trial within 60 days prior to baseline * Blood donation within 4 weeks prior to first vaccination. * History of autoimmune diseases, severe hypersensitivity reactions and anaphylaxis, allergic bronchial asthma and severe allergic rhinoconjunctivitis * Known hypersensitivity or allergic reaction to one of the components of the vaccine * A family history of congenital or hereditary immunodeficiency * Administration of chronic (defined as more than 14 days) immunosuppressant or other immune-modifying drugs within six months before first vaccination and during the entire study period. For corticosteroids like prednisone or equivalent ≥ 0.05 mg/kg/day. Topical and inhaled steroids are allowed * Intake of non steroidal anti-inflammatory drugs (NSAIDs) or paracetamol more than the basic medication for pain in the musculoskeletal system within three days prior to a vaccination with AFFITOPE® PD01A or AFFITOPE® PD03A or Placebo * If a patient shows an acute febrile infection (≥ 37.8° Celsius) on the day of vaccination, administration of Investigational Medicinal Product (IMP) should be postponed until resolution of the infection * Infection with the human immunodeficiency virus (HIV, a negative test result within 30 days before screening is acceptable), Hepatitis B (HBsAg) or Hepatitis C * Significant systemic illness (e.g. chronic renal failure, chronic liver disease, poorly controlled diabetes, poorly controlled congestive heart failure and/or other deficiencies), if considered relevant by the investigator * Venous status rendering it impossible to place an i.v. access * Contraindications for MRI and lumbar puncture * Not able to understand and comply with protocol requirements, instructions, protocol-stated restrictions * Unwilling to provide informed consent. Exceptions for patients who are physically not able to provide written informed consent (e.g. legal representative, consent via voce with witness)