MS news notes: EBV, stopping a DMT, 3 treatment reports

Welcome to “MS News Notes,” a column where I comment on multiple sclerosis (MS) news stories that caught my eye last week. This week, the stories cover research presented at the joint meeting of the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) and the Americas Committee for Treatment and Research in Multiple Sclerosis (ACTRIMS), held earlier this month in Milan.

Another angle on MS and EBV

A lot has been written about the connection between the Epstein-Barr virus (EBV) and MS. Most people carry EBV, a member of the herpes virus family that causes mononucleosis, in their body. But only a small number of them develop MS.

Research has reported that being infected by EBV raises the risk of developing MS by 32 times. Why is that?

As reported in the MS News Today story “ECTRIMS 2023: New research may help explain EBV and MS link,” it may be because of a combination of faulty immune regulation, genetics, and particular EBV strains.

“In statistical models, the scientists calculated that patients who had genetic risk factors and were infected with one of the EBV strains that upregulates HLA-E [an immune-modulating protein] were up to 260 times as likely to develop MS, compared with people without these genetic factors infected with other EBV strains,” the story says.

To me, this fact is all the more reason to push full speed ahead for the development of an EBV vaccine. Would you agree?

Recommended Reading

September 26, 2023 News by Marisa Wexler, MS

MS symptoms can fluctuate with Ocrevus, but ‘wearing off’ not likely

Stopping treatment leads to new disease activity in study

I often see questions on social media sites like the MS News Today Facebook page from people wondering if they should stop taking their disease-modifying therapy (DMT). These folks think that if their disease is stable, there’s no need to continue with their DMT, which may be expensive, difficult to administer, and cause side effects.

The takeaway from the story “ECTRIMS 2023: More disease activity when treatment stopped” is that no, patients shouldn’t stop.

This study aimed to determine if DMTs could be discontinued in people with stable disease. But the study was ended early because a number of participants who stopped their treatments experienced new disease activity that exceeded the study’s guidelines.

On the other hand, the story reports, “None of the patients who continued their DMT saw substantial disease activity, relapses, or significant MRI activity during the trial.”

I stopped my Lemtrada (alemtuzumab) treatments after the usual two rounds of infusions. But that was following treatment with three other DMTs, and I was also approaching 70 years old. That was about five years ago, and my progression hasn’t been what I’d consider significant since I quit. But everyone’s MS is different, and in general, I think people should remain on a DMT for as long as they can.

If you’ve stopped your therapy, why did you do it, and what were the results? Please share in the comments below.

A trio of positive treatment reports

Three additional studies that were presented at ECTRIMS should be encouraging to people with MS.

Foralumab is an antibody-based nasal spray that’s being tested on MS patients. Notably, its testing has involved people with nonactive secondary progressive MS, for which only one medication to date — mitoxantrone — has been authorized in the U.S.

“ECTRIMS 2023: Foralumab seen to ease brain inflammation in SPMS” looks at a small study of six people treated with foralumab. In that group, a decrease in microglial activity was seen in five of the six people. (Microglia cells in the brain may play a role in driving MS inflammation and nerve damage.)

Fenebrutinib is an investigational oral medicine designed to reduce MS inflammatory activity by reducing activity of B-cells and microglia immune cells. It does this by targeting Bruton’s tyrosine kinase, or BTK, a protein that’s required for this kind of inflammation.

“ECTRIMS 2023: Fenebrutinib lowers new lesions in relapsing MS” reports details of a study of 106 people with relapsing forms of MS whose symptoms started up to 10 years earlier. The study says that taking fenebrutinib for 12 weeks led to a 90% reduction in the number of new inflammatory lesions compared with a placebo. The patients being treated also had 49% fewer new or enlarging lesions after four weeks.

MS progression was the metric examined in a study discussed in “ECTRIMS 2023: Most on Zeposia see slower disability progression.” More than three-quarters of people with relapsing forms MS who received Zeposia (ozanimod) in a trial named RADIANCE and its extension study, had no disability progression after eight years of follow-up. More than 1,300 patients with relapsing forms of MS were enrolled in the study.

There’s no cure yet for MS, but these positive studies are just a small slice of the work that’s being done to curb MS progression.

Did you find this column helpful? Please share in the comments below. You’re also invited to visit my personal website at www.themswire.com.

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.