MS News That Caught My Eye Last Week: Tysabri, Evobrutinib, Diet Study, Rituximab

Drop in PML With Tysabri Use in Sweden Likely Due to Risk Management Plan

I’m JCV-positive, so I’m at risk for PML if I’m being treated with Tysabri. And I was treated with Tysabri for seven years without a problem. That, I believe, is because my neurologist carefully followed me with MRIs and blood tests, and because I dropped back from monthly treatments to a treatment every other month after two years. My Tysabri protocol seems similar to the risk management plan that’s being followed in Sweden, and also in France. It seems as if this sort of protocol could take a lot of the concern out of Tysabri treatment.

The number of cases of Tysabri (natalizumab) that are associated with progressive multifocal leukoencephalopathy (PML) — a serious brain infection — in multiple sclerosis (MS) patients living in Sweden fell between 2006 and 2018, a study shows.

Notably, the data highlighted that this drop was likely due to the introduction of a risk management plan (RMP) in 2012 that advises switching Tysabri-treated patients at risk of PML to other highly effective disease-modifying therapies (DMTs).

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EVOLUTION Trials Testing Evobrutinib Now Recruiting

Another MS treatment is starting clinical trials and recruiting test subjects. But once again, there’s a cutoff age for volunteers: 55. Why are older patients like me (I’m 72) often excluded from clinical trials? Do researchers think we no longer need DMTs? 

Two global Phase 3 clinical trials testing the investigational oral medication evobrutinib are recruiting participants with relapsing forms of multiple sclerosis (MS).

The two identically-designed trials — EVOLUTION RMS 1 (NCT04338022) and EVOLUTION RMS 2 (NCT04338061) — are specifically recruiting people with MS ages 18 to 55.

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Healthy Diet Linked to Better Mental, Physical Life Quality in Dutch Study

I frequently read in social media groups that cutting back on sugar, meat, and other “bad stuff” helps improve MS symptoms. Though the National MS Society says there’s no such thing as an “MS diet,” there are several diets that claim to be just that. The diet that people in this Dutch study followed is similar to those.

A healthy diet led to better physical and mental quality of life in Dutch adults with multiple sclerosis (MS), especially women, a large survey study found.

Substantial amounts of vegetables, fruits, fiber, and healthy fats were associated with better overall health in these MS patients, the scientists reported.

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Rituximab Before or During Pregnancy Not Linked to Major Complications

That’s an encouraging headline but please realize that only 19 women were observed in this study, the study only suggests that rituximab may not increase the risk of problems, and the “data collected so far are still insufficient to draw effective conclusions.” Please don’t jump to any.

Treatment with rituximab before or during pregnancy was not associated with major pregnancy or infant complications, according to a case series of 19 women with multiple sclerosis (MS) and other autoimmune diseases.

These findings add to the limited available evidence on the use of rituximab by expectant mothers either prior to or during pregnancy — a use strongly advised against by its manufacturer. The cases suggest that the therapy may not increase the risk of serious adverse events for either the mother or the baby.

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