Abstracts and Insights From the 2011 European Meeting in MS: Update on New Treatments, Clinical Aspects of MS, and Biomarkers CME (original) (raw)

s and Insights From the 2011 European Meeting in MS: Update on New Treatments, Clinical Aspects of MS, and Biomarkers CME Howard Zwibel, MD; Stephen Krieger, MD; Robert Lisak, MD; Andrew Wilner, MD CME Released: 12/09/2011; Valid for credit through 12/09/2012 Introduction Multiple sclerosis (MS) is a neurodegenerative disease that affects 400,000 people in the United States and more than 2.5 million worldwide.[1] It is generally believed to be an autoimmune disease, and it is the most common cause of nontraumatic neurologic disability in young adults.[2,3] Nearly 2 decades ago, the US Food and Drug Administration (FDA) approval of interferon beta-1b inaugurated the era of injectable disease-modifying therapies. Other injectable interferon-beta preparations and glatiramer acetate followed, and all offered reduced relapse rates with low potential for serious adverse events. In 2004, the introduction of natalizumab, a monoclonal antibody against alpha4-integrin that is administered by ...

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The present efficacy of multiple sclerosis therapeutics: Is the new 66% just the old 33%?

Neurology, 2009

A challenge for the clinician treating patients with multiple sclerosis (MS) is to determine the most effective treatment while weighing the benefits and risks. Results of the phase 2 and phase 3 studies on natalizumab were received with great interest, in part due to the "improved" risk reduction for relapse rate, disease progression, and MRI metrics observed in comparison to results in trials of beta-interferon and glatiramer acetate. However, comparison across trials is invalid, in large part due to differences in the study populations. The increased efficacy observed in more recent trials has also been attributed to a fundamental change in subjects with MS enrolled in recent trials compared with the prior decade. In this article, we debate the relative efficacy of natalizumab vs the older injectable therapies. Neurology ® 2009;73:984-990 GLOSSARY ARR ϭ absolute risk reduction; CIS ϭ clinically isolated syndrome; DMT ϭ disease-modulating therapy; EDSS ϭ Expanded Disability Status Scale; FDA ϭ Food and Drug Administration; GA ϭ glatiramer acetate; IFN ϭ interferon; MS ϭ multiple sclerosis; NNT ϭ number needed to treat; PML ϭ progressive multifocal leukoencephalopathy; RRMS ϭ relapsing-remitting MS; RRR ϭ relative risk reduction.

Natalizumab treatment in multiple sclerosis: the experience from two Brazilian MS centers Natalizumabe no tratamento da esclerose múltipla: a experiência de dois centros brasileiros

2020

Multiple sclerosis (MS) is a demyelinating, inflammatory disease of the central nervous system (CNS), presumably with an autoimmune etiopathogenesis. The first line therapies developed for the relapsing-remitting form of MS (RRMS) include disease modifying treatments (DMTs) as interferons (IFNs) beta and glatiramer acetate (GA) and they are known to be partially effective, with 20 -50% of treated patients experiencing a relapse or disability progression in a short period of time 1 . Natalizumab is a humanized monoclonal antibody that blocks the α-4 integrin, VLA-4, an adhesion molecule present on leukocytes surface, inhibiting their migration into CNS 2 . In the pivotal study AFFIRM, natalizumab reduced annualized relapse rate (aRR) by 68% and the risk of sustained disability progression by 42% over 2 years 2 . Although patients studied in AFFIRM were mostly treatment naïve RRMS patients, natalizumab is only approved for use in patient that failed treatment with DMTs or have highly ...

Anti-Integrin Therapy for Multiple Sclerosis

Integrins are the foremost family of cell adhesion molecules that regulate immune cell trafficking in health and diseases. Integrin alpha4 mediates organ-specific migration of immune cells to the inflamed brain, thereby playing the critical role in the pathogenesis of multiple sclerosis. Anti-alpha4 integrin therapy aiming to block infiltration of autoreactive lymphocytes to the inflamed brain has been validated in several clinical trials for the treatment of multiple sclerosis. This paper provides readers with an overview of the molecular and structural bases of integrin activation as well as rationale for using anti-alpha4 integrin therapy for multiple sclerosis and then chronicles the rise and fall of this treatment strategy using natalizumab, a humanized anti-alpha4 integrin.

Emerging data on the treatment of multiple sclerosis

2021

Background and objectives. In the past few years, a myriad of new studies were aimed to find better ways to manage MS. As a result, a bunch of new molecules were found to have good efficacy, therefore FDA and EMA approved a series of treatments in the last few years, the last one receiving green light from EMA on March 30th, 2021 (Ofatumumab-Kesimpta®). The aim of this study was to evaluate and classify three of the newest drugs approved by the FDA and EMA. Material and methods. All the studies were chosen on the basis of predetermined inclusion criteria and in accordance with PRISMA guidelines. We searched Pubmed and Cochrane Library for all studies published up until the end of 2020. For the data analysis we used MetaInsight®, a statistical web-based tool for meta-analyses and NMAs performing both Frequentist and Bayesian hierarchical model analyses, each one being seen as a sensitivity check for the other. Outcomes. The best therapeutic agent in reported efficacy amongst the three analyzed was Ofatumumab, ranked first in hierarchy, Ozanimod and Cladribine following in the second and third place, respectively. Conclusions. According to ABN's 2015 guidelines, Cladribine was ranked between the most effective medicines for the treatment of MS; given the results from this study, other two may be considered as high efficacy alongside Natalizumab, Alemtuzumab and Ocrelizumab.

Disease-Modifying Agents for Multiple Sclerosis

Drugs, 2008

Objective: To summarize major clinical trials which evaluate the efficacy and safety data of approved disease modifying agents for the treatment of various types of multiple sclerosis.

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