Research News on Secondary Progressive MS from ECTRIMS

Greetings from London, England, on the final day of the very busy ECTRIMS meeting. There have been more than 1500 research study results presented over the last few days. If anyone wants to see the depth and breadth of the research, the abstracts (summaries of conference presentations) are freely available here. Also, I hope you’ll catch other blogs by my colleagues related to HSCT, progressive MS, gut microbiome and coming up on Monday, symptoms and rehab solutions.
Beyond formal presentations, I think the best part of conferences like this one are the hallway conversations and spontaneous meetings that often lead to new collaborations and ultimately, new breakthroughs. At a conference as focused as ECTRIMS, the exchanges are, “all MS, all the time.”
I’ve heard a couple of presentations over the past few days that I found promising, since they focus on explorational treatments for people with secondary progressive MS, for whom there are few treatment choices.
You might remember my previous blog about an Oregon Health & Science University team led by Dr. Dennis Bourdette conducting a small, controlled clinical trial on lipoic acid. They provided an update of that study this week, showing that those taking lipoic acid had 66% less brain tissue shrinkage, or atrophy, than those who were taking inactive pills. This pilot study suggests potential benefits if they hold up in a larger, later phase trial. (Abstract 222)
At a previous ECTRIMS conference, Dr. Jeremy Chataway of University College London showed positive results from a phase 2 clinical trial of simvastatin, a commonly used oral cholesterol-lowering therapy. He found that the people with secondary-progressive MS who were taking simvastatin had less brain atrophy than people taking placebo. This week he presented further results suggesting that this positive effect of simvastatin against brain atrophy was also accompanied by a modest preservation of cognitive function, mostly related to memory. I’m excited that a phase 3 follow-up trial is planned to get underway in 2017. (Abstract 226)
In another study, Dr. Melissa Cambron and colleagues from Belgium looked at fluoxetine in primary and secondary progressive MS. This is the same compound as Prozac, and laboratory studies suggest it might prevent destruction of nerve axons by stimulating the energy metabolism in those cells. It also might improve blood flow in the brain. Investigators tested 40 milligrams offluoxetine given each day, in 69 people with MS compared to 68 who received placebo. The study lasted about 2 years. Unfortunately the trial did not meet its goal of reaching sustainable improvement in the 25-foot timed walk test. It also did not improve how one performs on the 9-hole peg test. While this is a discouraging result, they are still analyzing their data on cognition and imaging, so we hope to hear more about next steps for the study. (Abstract 253)
For many, the most anticipated results, presented this morning, were details from a large-scale, phase 3 clinical trial of oral siponimod in secondary progressive MS. Siponimod (BAF312, Novartis Pharmaceuticals AG) is an experimental immune system-modulating therapy, designed to act more selectively than Gilenya. It’s thought to act by keeping certain white blood cells out of the central nervous system. In August, preliminary results were announced from the 60-month, phase III clinical trial involving 1,651 people with secondary progressive MS. The trial met its primary endpoint of reducing the risk of disability progression compared with inactive placebo. Those on active treatment had a modest 21% reduced risk of disability progression compared to those on placebo. The medication showed a similar safety profile to others that work by preventing white blood cells from entering the central nervous system. (Abstract 250)
It’s great to see the emergence of new approaches to treating secondary progressive MS. I think this is just the beginning of a brighter future for people with this and other forms of progressive MS.
Tags Progressive MS, Research, Treatment      1

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.