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New MS Treatment Shows Promise in Trial

By Amy Norton

HealthDay Reporter

THURSDAY, Aug. 25, 2022 (HealthDay News) — An experimental antibody therapy for multiple sclerosis can cut symptom flare-ups by half, pitched against a standard treatment, a fresh clinical trial has found.

The drug, called ublituximab, beat a typical orally administered medication for MS in reducing patients’ relapses periods of new or worsening symptoms. In addition, it proved better at preventing regions of inflammatory damage in the mind.

Ublituximab isn’t yet approved for treating MS; the U.S. Food and Drug Administration is reviewing the trial data and is likely to decide by the year’s end, in accordance with drugmaker TG Therapeutics.

If approved, ublituximab will be the latest in a more recent band of MS therapies called anti-CD20 monoclonal antibodies: lab-engineered antibodies that target specific disease fighting capability cells that drive the MS process.

The brand new findings offer more proof that the approach benefits patients, in accordance with an expert who was simply not mixed up in trial.

“Is this revolutionary? No. But it’s further confirmation of a clinical reap the benefits of targeting this population of cells in the blood,” said Dr. Lauren Krupp, who directs NYU Langone’s Multiple Sclerosis Comprehensive Care Center in NEW YORK.

MS is really a neurological disorder that always arises between your ages of 20 and 40. It’s the effect of a misguided disease fighting capability attack on your body’s own myelin the protective sheath around nerve fibers in the spine and brain. Based on where in fact the damage occurs, medical indications include vision problems, muscle weakness, numbness, and difficulty with balance and coordination.

A lot of people with MS have the relapsing-remitting form, where symptoms flare for an interval, then ease. As time passes, the condition becomes more steadily progressive.

Disease fighting capability cells called B cells appear to play a particularly key role in driving MS. So modern times have observed the development of monoclonal antibodies that deplete the blood of B cells. One, called ocrelizumab (Ocrevus), was approved in the usa in 2017. Another ofatumumab (Kesimpta) followed in 2020.

Both antibodies deplete B cells by targeting a protein on the cells called CD20. Ublituximab gets the same target, but it’s engineered to become more potent at killing B cells, said Dr. Lawrence Steinman, lead researcher on the brand new trial.

The trial didn’t compare ublituximab against either existing anti-CD20 antibody, stressed Steinman, a professor of neurology at Stanford University. So it is not known be it any longer or less effective.

But a potential benefit of the brand new antibody, Steinman said, is that it could be administered rapidly.

Both Ocrevus and ublituximab require patients to visit a medical facility for infusions every half a year. But an Ocrevus infusion takes around three hours, while ublituximab could be given in a single hour.

Kesimpta, meanwhile, avoids infusions altogether. It’s taken in the home monthly, utilizing an auto-injector.

“You can find different solutions for differing people,” Steinman said. “I believe it certainly is good to possess options.”

The findings, published Aug. 25 in the New England Journal of Medicine , derive from a lot more than 1,000 patients with MS, mostly the relapsing-remitting form. A small % had secondary progressive MS, another phase of the condition that follows the relapsing-remitting years.

About 50 % were randomly assigned to ublituximab infusions, as the spouse took the orally administered medication Aubagio (teriflunomide).

Over 96 weeks, ublituximab patients were half as more likely to have a relapse having an average annual rate of slightly below 0.1, versus almost 0.2 among Aubagio patients. And on MRI scans, they showed fewer regions of inflammation in the mind.

B cells have the effect of churning out infection-fighting antibodies. So a primary safety nervous about B-cell depletion is that it could leave people more susceptible to infection. That has been the case in this trial: 5% of ublituximab patients developed a significant infection, including pneumonia, versus 3% of Aubagio patients.

There are several drugs approved to take care of MS. But Krupp said some recent studies are showing that patients fare better longterm if they get “high-efficacy” medications such as anti-CD20 antibodies versus older drugs with more-moderate effects.

To Steinman, earlier is way better with regards to starting high-efficacy treatment.

“My philosophy is, if insurance covers it, knock the condition down solid,” he said.

That introduces the real-world problem of cost: CD20 monoclonal antibodies are costly; the existing list price for Ocrevus is approximately $68,000 each year, in accordance with drugmaker Genentech.

Frequently, both Krupp and Steinman said, medication decisions be determined by those are included in a patient’s insurance coverage.

More info

The National Multiple Sclerosis Society has more on treating MS.

SOURCES: Lawrence Steinman, MD, director and professor, neurology and neurological sciences, and pediatrics, Beckman Center for Molecular Medicine, Stanford University, Stanford, Calif.; Lauren Krupp, MD, director, NYU Langone Multiple Sclerosis Comprehensive Care Center, and professor, pediatric neuropsychiatry, NYU Grossman School of Medicine, NEW YORK; New England Journal of Medicine, Aug. 25, 2022

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