MS News That Caught My Eye Last Week: Early MS, Fenebrutinib, Restless Legs, Safer MRIs

Phase 4 Trial Will Test if Ocrevus Can Prevent MS Onset in RIS Patients

Yes, you’re reading this right. This trial aims to see if Ocrevus can stop MS before it’s officially diagnosed — when it may be smoldering and presenting a minimum of MS-like activity. In July, this global trial is expected to begin enrolling people who have been classified with radiologically isolated syndrome.

Yale University is launching CELLO, a multicenter study to investigate the efficacy of Ocrevus (ocrelizumab) in treating people with lesions suggestive of multiple sclerosis (MS), a condition known as radiologically isolated syndrome.

The Phase 4 study (NCT04877457) aims to evaluate whether short-term treatment with Ocrevus can delay or prevent the onset of MS in radiologically isolated syndrome (RIS) patients. These patients have no evident neurological MS symptoms, but MRI scans show disease-related brain and/or spinal cord lesions.

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Global Phase 3 Trials of Fenebrutinib Enrolling Relapsing and PPMS Patients

There aren’t a lot of treatment options available for people with primary progressive MS, so it’s encouraging to learn of a trial enrolling folks with it. Fenebrutinib, the medication being studied in all three trials, is designed to slow MS progression by blocking B-cells from driving the inflammation that damages nerve cells.

Two global Phase 3 clinical trials comparing fenebrutinib, an investigational oral BTK inhibitor by Roche, with Aubagio (teriflunomide) are now enrolling adults with relapsing forms of multiple sclerosis (MS), the National MS Society announced in a press release.

The twin studies, called FENhance 1 (NCT04586023) and FENhance 2 (NCT04586010), aim to enroll a total of 1,468 adults, ages 18 to 55, diagnosed within the last 10 years with relapsing MS, which includes relapsing-remitting (RRMS) and active secondary progressive (SPMS) disease. These trials are recruiting at sites in the U.S., Canada, Europe, Argentina, Peru, Korea, and Turkey. Contact and location information is available here and here.

A separate Phase 3 trial, called FENtrepid (NCT04544449), is enrolling up to 946 primary progressive MS (PPMS) patients, ages 18 to 65. Participants are being recruited at 70 sites worldwide — including across the U.S., Canada, and Europe — and will be randomly assigned fenebrutinib or Ocrevus (ocrelizumab) for 120 weeks (about 2.3 years).

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Restless Legs Syndrome More Common With Greater Disability, Spinal Lesions

Do your legs kick around in bed at night? Mine have for years, and for years, my neurologist has told me it is typical of spinal nerve damage in MS. This report also says that restless legs syndrome interferes with our sleep. I’m not surprised. Of greater interest to me is whether DMTs alleviate the restless legs problem. Unfortunately, according to this report, they do not.

Restless legs syndrome, the name given to the considerable discomfort people feel in their lower limbs, accompanied by an irresistible urge to move them, more frequently affects multiple sclerosis (MS) patients than the general public, and significantly impacts sleep quality, a case control study shows.

While the type of MS treatment used was not associated with this syndrome’s presence, it was found to be more likely in patients with greater physical disability and spinal lesions.

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US Patent Issued for Software That Could Make MRI Scans Safer

In the more than 40 years I’ve lived with MS, I’ve had countless MRIs, nearly all of them using gadolinium-based contrasting agents. I think that using it to light up lesions in the brain that might otherwise be invisible — and at the same time, alerting my neurologist that a treatment change might be needed — was worth the small risk that the gadolinium might harm me. But I’d be delighted if the same results could be achieved using 90% less of this contrast agent, which is exactly what this new artificial intelligence technology hopes to achieve. I hope it works as well as its inventors expect.

Subtle Medical announced the granting of a U.S. patent for its radiology software that uses artificial intelligence to improve the quality of medical imaging, with the potential to reduce the amount of gadolinium, a contrast agent, needed to one-tenth of its usual dose.

Gadolinium, a heavy metal, is included in contrast agents delivered through intravenous injection, and used in about one in every three magnetic resonance imaging (MRI) scans to improve the visibility of internal tissues, blood vessels, and organs. This contrast agent is often given to people with multiple sclerosis (MS), who undergo these scans to detect areas of active inflammation in the brain.

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