Promising Therapies on the Horizon for All Forms of MS

There was a lot of excitement at ECTRIMS this week about the emergence of new treatment approaches for all forms of MS, even progressive.

Earlier blog posts have already covered emerging therapies including stem cells, nervous system repair strategies and rehabilitation and wellness approaches. So this report focuses on results from experimental therapies that are well on their way to being available to people with MS.

Making perhaps the most “buzz” were results presented on studies of the monoclonal antibody ocrelizumab, in relapsing remitting and progressive MS.  Ocrelizumab targets a protein that appears on immune B cells during specific stages of their life cycle. B cells make antibodies to help fight infection and perform other functions to stimulate the immune system. Scientists believe ocrelizumab destroys the group of B cells that include those that contribute to MS, but leaves other B cells intact that are fighting infections or are prepared to fight new ones.

A highly anticipated presentation described the results of a clinical trial of ocrelizumab involving 732 people with primary progressive MS. Participants were given either ocrelizumab or inactive placebo by in-vein infusions about every 6 months. Results showed that compared to placebo, ocrelizumab significantly reduced the risk of progression of clinical disability (according to the standard EDSS scale) by 24%, and had other positive outcomes. The main side effects were reactions to the infusions, and the incidence of serious infections was relatively low. (Abstract 228) This is the first large-scale clinical trial to show positive results in people with primary progressive MS. We don't yet know what mechanism might be driving these results in progressive MS, so we are eager to see more information when these results are published. For more information, click here.

In addition results were presented from two phase III trials of ocrelizumab in relapsing MS.  In both trials the treatment performed very well against Rebif in people who had never been on any MS therapy as well as those who had tried other therapies. The reported results showed that ocrelizumab reduced the risk of relapse by 46 to 47% compared to Rebif, reduced the risk of disease progression by 40%, and had other positive outcomes. (Abstract 190)  The sponsor, Genentech (a member of the Roche Group) stated that it plans to apply for marketing approval from the FDA in early 2016.  This was a significant set of results as it identified a new approach to modulating the immune system in MS.

Another intriguing trial result came from a dedicated group of investigators led by Dr. Luanne Metz (University of Calgary) who conducted a Phase III trial of a relatively inexpensive oral antibiotic called minocycline. Minocycline has been on the market for decades and is often prescribed to treat acne, and in addition to its bacteria-killing action, it reduces inflammation.

The trial tested minocycline against placebo in 144 people across Canada who had clinically isolated syndrome (CIS) – which means they have early possible signs of MS but haven’t yet shown enough signs or symptoms to be diagnosed with definite MS. The goal was to determine if minocycline, taken orally at a dose of 100mg twice a day, could reduce the proportion of participants with CIS who converted to MS over a 6-month follow-up period. The secondary objective was to determine whether the effect could last up to two years. Their results showed that over 6 months, those taking twice daily minocycline had a 44.6% reduced risk of developing definite MS, compared to those taking placebo. There were no unexpected side effects reported from the trial outside of the most common that occur in some who take this antibiotic, including potential for diarrhea; dizziness or light-headedness; grey discoloration of the skin or tissue in the mouth or teeth; sun sensitivity and secondary infection due to fungi. (Abstract 227)

These results bring up a lot of questions, such as: What are the longer-term benefits or side effects? Would this help people who already have MS? Would a generic drug like this ever become approved by regulators? Would its price alone influence doctors to prescribe it?

These are only a few of many new approaches being explored to stop the MS process and restore function. If you are interested in these and the many other reports from ECTRIMS, visit the ECTRIMS Website and browse the hundreds of abstracts to get an idea of what solutions are on the horizon for people with MS. One important caveat –everything presented at a meeting such as ECTRIMS is considered preliminary until it has been thoroughly peer-reviewed for publication in a respected journal - so the information shared here is based only on the preliminary information we’ve heard so far.

 

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Mark

Mark Allegretta, PhD

Dr. Mark Allegretta is the Vice President of Research at the National MS Society, leading commercial research including partnerships developed through Fast Forward. He brings expertise in immunology and 28 years of experience in biotechnology and pharmaceutical operations to help drive the development of new therapies to stop MS and restore function.

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    20 Comments

  • Landon Blair   Oct 13, 2015 7:19 AM
    Good information!
  • Dave   Oct 13, 2015 4:09 PM
    Does this include secondary progressive? Please say yes!
  • Vanessa Dubetsky   Oct 14, 2015 12:51 PM
    Interesting article. An antibiotic. MS could be bacterial? or is the antibiotic simply treating the symptom of inflamation. The inflamation is what brings the decline in neural functioning. Where can I find out more....started many years ago in Bio Sci, failed Organic Chem, but I did understand some things and I love to think outside the box. This article seems outside the box.
  • Karen A. Salazar   Oct 14, 2015 9:39 PM
    i am the youngest of 5 sisters. My 5 & 4 oldest sisters were diagnosed at 38 years of age with Progressive M.S. . My 4th oldest died because of others issues but my eldest sister is still alive and all her lesions have done all the damage they could do. I was 55 years old 8/31/12 I received a flu shot and I soon diagnosed with relapsing Remitting MS . I was wondering if we would be candidates in a study to have 3 out of 5 to have some form of MS. My eldest sister said she would if I would just wondering. We also had an uncle on our fathers side whom had progressive MS.
    Sincerely, Karen salazar
  • Thomas   Oct 15, 2015 6:37 AM
    Wow Karen I had a flu shot and after a week had an attack and was said to have relapse remitting too. Never had any issues before that would hinted at ms. Get a flu shot and bam. Glad I am not the only one . No one wanted to hear it could of been flu shot related
  • Debbie Williams   Oct 15, 2015 8:32 AM
    My husband has relapsing/remitting MS for 13 years now. He had the flu shot early on and right afterwards, had a really bad relapse. We decided for him not to get the flu shot anymore, even though some of his doctors tried to push for it. He has not gotten the flu and his last flu shot was 12 years ago. I noticed in the article discussing the flu shot, if you have recently been on steroid treatments, you could have a bad reaction, which he was at the time.
  • Avatar
    tlcpro  Oct 15, 2015 8:41 AM
    Why are MS therapies so freakin expensive? If I lose health care coverage, I won't be able to afford this stuff. How can a company justify charging more than a person makes in a year for these drugs? It is ridiculous to expect anyone to pay $5,000 a month for a generic and $6544.00 for the name brand when in Europe the cost is only $1200.00. Are these therapies doomed to be expensive as well?
  • Aly   Oct 15, 2015 9:25 AM
    To Karen A. Salazar,

    Take a look at this study for you and your sisters: http://dejager_lab.bwh.harvard.edu/?project=featured-projects and https://www.facebook.com/Genes-and-Environment-in-Multiple-Sclerosis-GEMS-Research-Study-200900853288242/

    Best,
    Aly
  • Dorothy levinson   Oct 15, 2015 10:31 AM
    Have there been any scientific studies where the blood was completely replaced by infusion, which would be a less agressive way to introduce healthy stem cells?
  • tessa   Oct 15, 2015 10:59 AM
    secondary progressive MS needs more attention!
  • Wayne   Oct 15, 2015 11:45 AM
    My older sister and I have both been diagnosed, her relapsing and mine progressive. Seems all therapies are for relapsing and none for mine. She is 10 years my senior and is in way better shape than me. Since I hit about 55 it has excellerated and I hope some therapies come of this for me.
  • Ken   Oct 15, 2015 11:51 AM
    I'm in the extended trial for ocrelizumab for the past year and it works very well. Three years ago I started in the first double blind trial where I now know I was receiving Rebif for the entire 2 year trial. after the two years I was asked to participate in the extended trial with only ocrelizumab being administered, so I am able to compare the two. The effects are night and day, although it's not a cure I feel a million times better than I did on Rebif with very few side effects.
  • Priscilla   Oct 15, 2015 2:22 PM
    Wow Thomas and Karen. I also had my first ms attack after a flu shot. I was dismissed just as others were. I'm actually quite upset reading these comments because I know now I am not the only one who was completely dismissed when I made the same complaints. I had absolutely no ms symptoms before that stupid shot. I was actually a very healthy 25-year old woman. I wish you all the best!
  • Lance  Oct 16, 2015 1:36 PM
    Concerning the fungal and antibiotic theories, I would be interested in knowing more about the affects of early age, high dose antibiotic treatments. I'm 52, I have primary progressive ms, I was hospitalized at age 11 with a severe infection, inundated with high doses of antibiotics which I believe compromised my undeveloped immune system whereby in hind sight shortly after, shuffling my feet when I walked and slowing down in running etc. I was finally diagnosed many years later due to MRI/ contrast development so I would like to see more studies involving fungal and antibiotics relating to MS.
  • susan   Oct 19, 2015 2:47 AM
    very informative article. thanks for sharing.
    susan
    http://www.creative-proteomics.com/product/detail-HA-PCP-PAG_34375.htm
  • McLinn   Oct 20, 2015 9:42 PM
    Is there any anecdotal or research information/conclusions regarding the use of Accutane for cystic acne doing damage to the myelin or being related, in any way, to the onset of M.S. ?
  • Tim   Oct 26, 2015 7:53 PM
    Help Fight MS !!!! Please support someone fighting this disease. https://www.gofundme.com/Beat-M-S
    Share it, like it, donate or all Thank You
  • jen   Oct 29, 2015 1:55 PM
    Or is there a cure for ms along with cancers and other diseases put away. Because if we were all cured how would big Pharmaceutical make all its money annually?
  • susan ransone   Nov 10, 2015 3:32 PM
    VERY INTERESTING ABOUT MINOCYCLINE STUDY. I HAVE KNOWN FOR DECADES NOW THAT THE BEST I DO WITH MS IS WHEN I HAPPEN TO NEED AN ANTIBIOTIC FOR AN UNRELATED INFECTION. HOWEVER, A COUPLE DAYS AFTER FINISHING THE ANTIBIOTIC YOU EXPERIENCE QUITE A MS EXACERBATION. THIS ROLLER COASTER EFFECT IS SIMILAR TO SOLUMEDROL THERAPY. FORTUNATELY, I HAVEN'T REQUIRED TOO MANY ANTIBIOTICS OVER THE YEARS. ALSO, A NUMBER OF YEARS AGO I MENTIONED THIS TO A NEUROLOGIST HOPING TO FIND OUT WHY AND TOLD HIM I WOULD DO GREAT IF I TOOK ANTIBIOTICS ALL THE TIME. SO MAYBE THERE IS SOMETHING TO THIS. KEEP CHECKING IT OUT. GOD BLESS.
  • mar//   Feb 1, 2016 9:08 AM
    sten m celllxcdells and msareality?