Advances in multiple sclerosis research and the development of new treatments over the last several decades give sustained reasons for hope as continue moving toward our future, according to Jerry S. Wolinsky, a neurologist and MS specialist whose career spans more than 40 years.
In a wide-ranging interview with Multiple Sclerosis News Today at the recent 34th congress of the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS), Wolinsky discussed the latest findings on evobrutinib, current therapeutic strategies in MS, as well as potential new targets and their challenges.
Wolinsky is a professor emeritus in the department of neurology at the McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth). He is past chair of the Research Programs Advisory and National Medical Advisory Committees of the National MS Society, and a past president and emeritus board member of the Americas Committee for Research in Multiple Sclerosis (ACTRIMS).
Evobrutinib and a potential ‘on-off switch’
The development of disease-modifying therapies (DMTs) for MS started with formulations of interferon — currently sold under trade names such as Rebif (by EMD Serono), Avonex (by Biogen), and Betaferon/Betaseron (by Bayer) — and glatiramer acetates like Copaxone by Teva Pharmaceuticals, and Glatopa by Sandoz.
Although not in a predictive way, the initial studies with interferon and glatiramer acetate “have taught us a lot about who does respond and who doesn’t respond,” Wolinsky said, “but most importantly, we know a lot about their safety. And so, if anything, they to me become the hurdle to clear in terms of safety for the subsequent drugs.”
These newer therapies generally show themselves to be superior, “but maybe not safer” than those first approaches. Later immune-targeting antibodies also demonstrated high efficacy in general, but with different side effect profiles — all of which need to be considered in treating a person.
“So, yes, there’s a lot of decisions to make about picking and selecting the right drug for the right patient at the right time. And I’d be foolish if I’d tell you I could give you the right formula, because that would mean I don’t know enough to be confused by what’s out there,” Wolinsky said.
Investigational therapies now in development on the ability to halt inflammatory attacks, which possibly underly the development of brain lesions and mechanisms that damage the brain.
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