MS Wrap-up: Research Needs in Progressive MS, AAN Annual Meeting, and More

A Call to Action Issued for MS Research Community

The International Progressive MS Alliance is calling for more research into progressive multiple sclerosis (MS), as well as an increase in funding for individuals with the disease, according to NeurologyLive®.

A recent interview with Kathy M. Zackowski, PhD, OTR, senior director, patient management, care and rehabilitation research, National MS Society, expounded upon the most urgent research needs in the space, which focus on 4 symptoms: fatigue, pain, mobility and upper extremity impairment, and cognitive impairment.

Patients with progressive MS have few treatment options, Zackowski highlighted, despite the disease having far-reaching effects on cost of care, familial stress, and employment. As the first author of the article that is calling for change in this area due to a lack of studies among the patient group, she notes the urgent need for faster targeted research that focuses on rehabilitation and not just symptom management to improve quality of life.

EMPhASIS Trial Findings on IMU-838 for RRMS

Relapsing-remitting multiple sclerosis (RRMS) may have a new treatment option in oral vidofludimus calcium (IMU-838), according to research presented at this year’s American Academy of Neurology Annual Meeting by Robert J. Fox, MD, neurologist, Mellen Center for Multiple Sclerosis, and vice-chair for research, Neurological Institute, Cleveland Clinic.

A possible reduction in combined unique active (CUA) MRI lesions in patients with RRMS was seen following administration of the treatment in the EMPhASIS trial, which compared 2 doses of IMU-838 (30 and 45 mg) with placebo in 209 patients. Reported by NeurologyLive®, per Fox, advantages of the treatment include its improved safety and tolerability profile vs teriflunomide, a short half-life of 30 hours, and just 6 to 8 hours to reach a steady state.

In addition, IMU-838 did not result in liver irritation, reduced white blood cell count, or renal impairment. The 24-week trial saw an overall 62% to 70% drop in CUA MRI lesions among both study groups.

Studies Investigate Anakinra, Tolebrutinib in Progressive MS

A pair of studies presented at this year’s Americas Committee for Treatment and Research in Multiple Sclerosis Forum investigated the use of anakinra, a human interleukin-1 (IL-1) receptor antagonist, and tolebrutinib, a brain-penetrant Bruton tyrosine kinase inhibitor.

In an interview with NeurologyLive®, senior author Daniel Reich, MD, PhD, senior investigator, National Institutes of Neurological Disorders and Stroke, highlighted the chronic inflammation often seen in the brain with progressive MS and how anakinra and tolebrutinib are able to cross the blood-brain barrier to work against IL-1 receptors and innate immune cells, respectively. Acute inflammation from MS can be stopped with a disease-modifying therapy, but the chronic inflammation seen in the brain never resolves, Reich noted.

In addition to the innate immune cells, lymphocytes and T and B cells may be to blame for that chronic inflammation. This is the first time that the FDA-approved anakinra has been trialed in MS, while tolebrutinib is an investigational agent.