MS News that Caught My Eye Last Week: Injectable DMTs, Ofatumumab ‘Success Story,’ MS and Night Shift Work, MS Biomarker Study

#ECTRIMS2019 – Are Injectables Inappropriate for Active Relapsing MS Treatment?

Injectable disease-modifying therapies (DMTs) have been around for a long time. I took part in a Phase 3 clinical trial for Avonex (interferon beta-1a) in the mid-1990s. These treatments were the only game in town back then, and those of us who were treated with DMTs considered ourselves lucky. Today, however, more than 15 DMTs are available in most high-income countries, and doctors and patients report that some of them are more effective than the injectables. At the recent ECTRIMS conference, a debate took place about whether injectables are still the best choice for some patients.

With more high-efficacy therapies becoming available, is it now inappropriate to prescribe older injectables — interferon beta and glatiramer acetate — to people with active relapsing multiple sclerosis (MS)?

This question was at the core of what was called a “burning debate” at this year’s European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) Conference, recently held in Stockholm, in which two speakers discussed the benefits and risks of low- versus high-efficacy disease-modifying treatments.

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#ECTRIMS2019 – Ofatumumab Part of ‘Magnificent Success Story’ for MS, ASCLEPIOS Trial Investigator Says

I’m a little skeptical when I read superlatives such as “magnificent success” used about any discovery, especially in the pharmaceutical world. But it does appear that this disease-modifying therapy, which is in Phase 3 trials, is worth watching. Like Ocrevus (ocrelizumab), ofatumumab targets B-cells. Unlike Ocrevus and rituximab, however, it’s given as a monthly injection rather than a twice-yearly infusion.

Ofatumumab, an investigational B-cell therapy being developed by Novartis, demonstrated encouraging results in lowering relapse rates and active brain lesions in people with relapsing multiple sclerosis (MS) enrolled in the ASCLEPIOS trials.

For Stephen L. Hauser, MD, an investigator in the ASCLEPIOS trials, these results represent a decades-long journey to better understand MS and what he calls a “magnificent success story” in the overall treatment of the disease.

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Decades of Night Work Tied to Nearly 3 Times Higher MS Risk, Studies in Nurses Suggest

I spent many years working in broadcast journalism, a profession that requires someone to be on duty 24/7. Throughout my career, I heard talk about how working the overnight shift, roughly midnight to 8 a.m., took a toll on a person’s health no matter how much sleep they got. This study reports that the problem, at least related to multiple sclerosis (MS), could lie with rotating between day and night shifts over two decades or more.

Occasional, or rotating, night shift work, even if done over a decade, does not seem to be directly linked to a higher risk of multiple sclerosis. But working nights for more than 20 years — and likely beginning such shifts early in a career — carries an almost three times higher risk of a definitive MS diagnosis, results of a large-scale study in nurses suggest.

These findings were reported in “Rotating night shift work and risk of multiple sclerosis in the Nurses’ Health Studies,” published in the journal Occupational and Environmental Medicine.

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Interleukin-22 May Be Biomarker to Monitor How Well RRMS Patients Respond to Therapy

We’re all familiar with the clinical tests and MRIs that doctors use to try to determine how quickly our multiple sclerosis is progressing. This research examined whether a test can be created to track MS progression and assess the effectiveness of treatments by examining a molecule in blood serum.

The levels of the inflammatory molecule interleukin-22 (IL-22) may be used as a potential biomarker to evaluate disease severity and the effectiveness of treatments in patients with relapsing-remitting multiple sclerosis (RRMS), a new study shows.

The study, “Impact of interferon β-1b, interferon β-1a and fingolimod therapies on serum interleukins-22, 32α and 34 concentrations in patients with relapsing-remitting multiple sclerosis,” was published in the Journal of Neuroimmunology.

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