ATA188 is an experimental therapy being developed by Atara Biotherapeutics to treat both progressive and relapsing-remitting multiple sclerosis (MS).

How ATA188 works

MS is a neurodegenerative disorder characterized by the immune system mistakenly attacking the myelin sheath — the protective coating that surrounds the nerves. Without the protection of myelin, nerves are fragile and easily damaged, leading to neurodegeneration.

One cause of MS may be the Epstein-Barr virus (EBV), which infects B-cells (a type of immune cell that produces antibodies). These antibodies are much more likely to be autoreactive or may erroneously attack the body’s own cells and tissues. People with MS are thought to have fewer T-cells (another type of immune cells), which, in combination of an EBV infection, could contribute to the development of MS.

ATA188 is an immunomodulatory molecule (a molecule that modulates the immune response) that “teaches” T-cells to recognize and destroy EBV-infected cells, thereby reducing the antibodies produced by these cells against the myelin sheath and, as a result, possibly slow or halt disease progression.

ATA188 in clinical trials

A Phase 1 clinical trial (ACTRN12615000422527) tested the safety and tolerability of ATA188 in patients with primary and secondary progressive MS. The results of the study were published in JCI Insight.

Of the 13 recruited patients, 10 received the full course of treatment with ATA188. Seven patients showed improvements, with six demonstrating improvements in symptoms, including a reduction in fatigue and an improved quality of life. In three patients, a reduction in auto-antibodies was observed in the cerebrospinal fluid (the fluid that surrounds the brain and spinal cord). There were no reports of serious adverse events associated with the treatment.

A Phase 1 clinical trial (NCT03283826) is currently recruiting patients with relapsing-remitting MS and progressive MS to determine the safety and tolerability of ATA188 as well as the best dose for a Phase 2 clinical trial.

The trial aims to recruit a total of 60 patients who will receive intravenous infusions of ATA188 at treatment centers in Arizona, Louisiana, Pennsylvania, Texas, and Australia. Beginning 28 days after the last infusion, patients will enter a follow-up period with 12 monthly visits and an end-of-study visit two years after the initial infusion.

Atara is expected to announce the preliminary results from this trial at the 5th Congress of the European Academy of Neurology.

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