MS News That Caught My Eye Last Week: ‘Cog Fog,’ Tolebrutinib, Ublituximab, Spinal Atrophy

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by Ed Tobias |

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#ACTRIMS2022 – Cognitive Training Paired With tDCS Aids Patients

A treatment to clear “cog fog” would be welcomed by many people with MS. Over 75% of us are troubled by cognitive problems. In this study, adding painless transcranial direct current stimulation to standard cognitive training improved results when compared with standard cognitive training alone.

Electrically stimulating the brain while doing at-home cognitive training games can help to prevent a decline in cognition for people with multiple sclerosis (MS), particularly those with more advanced disability, a study indicates.

“This could lead to a therapy that can remediate cognitive impairment, we just need to optimize” the intervention protocol, said Leigh Charvet, PhD, a professor in the neurology department of New York University.

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#ACTRIMS2022 – Tolebrutinib More Potent Than Other BTK Blockers

Several months ago, I wrote about the possibility of BTK blockers becoming the next big MS treatment. There are several oral BTK blockers in Phase 3 clinical trials right now. This study singles out one of them, tolebrutinib, as being better than others. Note, however, that the study was conducted by Sanofi, the pharmaceutical company that is developing tolebrutinib.

Tolebrutinib, an investigative inhibitor of Bruton’s tyrosine kinase (BTK) being developed by Sanofi to treat all forms of multiple sclerosis (MS), shows the potential to be more potent than other BTK inhibitors also in advanced clinical trials, scientists reported.

The findings, based on preclinical data, were shared at the Americas Committee for Treatment and Research in Multiple Sclerosis (ACTRIMS) Forum 2022 in the poster presentation “Comparative CNS Pharmacology of Tolebrutinib Versus Other BTK Inhibitor Candidates for Treating MS.”

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#ACTRIMS2022 – Ublituximab Eases Brain Lesions Better Than Aubagio

Here’s another comparison of medications. In this case, the study compares the investigational ublituximab with Aubagio, which has been around for more than a decade. Once again, note that the research has been paid for by the pharmaceutical company that’s developing the experimental treatment, TG Therapeutics.

The experimental medication ublituximab significantly reduces the number of new brain lesions with severe nerve cell degeneration in people with relapsing multiple sclerosis (MS) as compared with Aubagio (teriflunomide), according to new data from the Phase 3 ULTIMATE clinical trials.

The findings showed that ublituximab induces a rapid and sustained reduction in the number of B-cells, a type of immune cell that drives inflammation, in people with MS. Moreover, neutralizing antibodies were identified in only a small proportion of ublituximab-treated patients — and these antibodies did not seem to impact B-cell depletion or relapse rates.

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#ACTRIMS2022 – Spinal Cord Atrophy Predicts ‘Silent Progression’ in Early MS

This study looked at something I’ve experienced personally. My walking got worse even though my relapses had stopped. My neurologist explained that it was due to hard-to-see lesions on my spinal cord. Frankly, I thought a study such as this would have been conducted long ago.

A faster rate of atrophy in the spinal cord of people in earlier stages of multiple sclerosis (MS) is likely to indicate “silent progression” — worsening disability in the absence of relapses — and a swifter conversion to secondary progressive MS (SPMS), new data show.

Antje Bischof, MD, with University Hospital Munster in Germany, shared these findings at the Americas Committee for Treatment and Research in Multiple Sclerosis (ACTRIMS) Forum 2022. Her presentation was titled “Spinal Cord Atrophy Predicts Silent Progression in Relapse-onset Multiple Sclerosis.”

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Note: Multiple Sclerosis News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Multiple Sclerosis News Today or its parent company, BioNews, and are intended to spark discussion about issues pertaining to multiple sclerosis.


Robert Nicoloro avatar

Robert Nicoloro

Doctors are reluctant to test for antibodies for measuring and demonstrating % protection to COVID for MS patients. Is there a reason for the reluctance?

Ed Tobias avatar

Ed Tobias

Hi Robert,

I think there's a general reluctance to test for antibodies, but I don't know why. I think perhaps it's because of an uncertainty about what level of antibodies is necessary to be considered a protective level. There have been several studies, however, about how much protection the COVID-19 vaccines provide to people with MS. A search of this website should produce a number of them, if you're interested.


Rosanne Costain avatar

Rosanne Costain

I do not receive any treatment for my MS, however, a number of years ago I had my artery on the right side of my neck opened and that cleared my brain fog after about 6-8 weeks. I am now at year 35 for MS and other than osteo arthritis in my spine, I do stretching exercises and weight lifting with 3 LB weights. At 68 years old, I feel pretty good.
Wish the clinic would suggest a treatment, but, so far they haven't. I get a lot of information from MS daily.

Ed Tobias avatar

Ed Tobias

Hi Rosanne,

Thanks for the info your artery and your brain fog. That's very interesting and something I've never heard of before. Did your doctor directly connect the brain fog to your MS and the improvement to the surgery on the artery?

I'm sorry you've had to go without a treatment but pleased that you're getting a lot of info from us.


Paula Mieczkowski avatar

Paula Mieczkowski

Hi Rosanne, Paula here from West by God, Virginia. Hope things are well with you. Your post was interesting to me. I’m 70 and have ms since I was around 35. Cog fog or Guess I just don’t want to know. No longer on a dmt. Was on Rebif for years. At 65 I said enough. The docs won’t order many tests because most of the ones we need aren’t covered under Medicare even supplemental. It sux but big brother won’t budge.


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