Multiple sclerosis (MS) is a neurodegenerative illness that affects about 2.8 million people throughout the world. Although there is no currently a treatment for the condition, medications are available to help slow its progression.
Through a phase 3 clinical study for the medicine rituximab, a team of researchers from the Karolinska Institutet and Danderyd Hospital in Sweden wants to expand the list of currently available therapies.
Rituximab helped lower relapse risk in MS patients, according to study findings, compared to patients receiving the standard treatment drug dimethyl fumarate.
The paper has just been published in the Lancet.
What are the definitions of MS relapses?
MS affects a person's central nervous system, including the brain and spinal cord. The condition damages a substance called myelin, which protects the body's nerves.
MS is divided into four main types. The most common type is relapsing-remitting MS, which affects about 85% of MS patients.
Patients with RRMS experience inflammatory assaults on the myelin surrounding their nerves, which may present new or worsening symptoms. Each relapse is followed by a time period of partial or complete recovery, known as remission.
Research shows that RRMS can also lead to other issues, such as brain atrophy, increased stress, and decreased self-esteem.
MS relapses are the tip of the iceberg in MS inflammatory activity, according to Prof. Anders Svenningsson, the first author of this study.
Patients with MS will be able to live as normal a life as possible while minimizing the risk of long-term disease by preventing relapses to a great extent, according to Medical News Today.
Different MS relapse treatment strategies are discussed in this article.
There are currently a number of safe and effective treatments for MS, including injectable medications, such as ofatumumab (Kesimpta), oral medications, such as dimethyl fumarate (Tecfidera), and drugs delivered via injection, such as ocrelizumab (Ocrevus).
rituximab, an innovative medicine that was originally developed to treat lymphoma, is becoming used in Sweden as an off-label treatment for MS.
We saw the potential of rituximab as an effective and inexpensive therapy and wanted to gather the best possible evidence for its efficacy, said the author. We then wanted to compare it with one of the most effective first-line therapies in MS to position rituximab as an effective first-line therapy.
Prof. Svenningsson and his colleagues conducted a phase 3 clinical investigation on the use of rituximab (MabThera) to dimethyl fumarate (Tecfidera) as a therapy in 195 new RRMS patients. Dimethyl fumarate is a medicine developed for the treatment of persistent MS patients.
Patients treated with rituximab were five times less likely to relapse in comparison to patients treated with dimethyl fumarate in the clinical trial.
Patients receiving rituximab had fewer new MS plaques or areas of scarring on the central nervous system than those receiving dimethyl fumarate, according to magnetic resonance imaging (MRI).
Prof. Svenningsson believes rituximab is an effective treatment for MS patients because it eliminates B-lymphocytes in the blood, which prevents the immune system from attacking its own tissue.
According to him, by doing so, immune cells will not invade the central nervous system and thus will not create the major inflammations that result in relapses.
Another advantage of rituximab is that it is administered in extended intervals, according to Prof. Svenningsson. Patients received rituximab injections every 6 months during the phase 3 clinical study.
According to him, patients do not have to worry or think about their condition more than a couple of days a year between treatments.
Physicians may receive new information as a result of the available data.
MNT also spoke with Dr. Barbara Giesser, a neuroscientist and MS specialist at the Providence Saint Johns Health Center in Santa Monica, CA, about this clinical study.
Although clinicians were aware rituximab was a more effective MS medication than dimethyl fumarate, this study provides a needed head-to-head comparison.
Dr. Giesser noted that this study supports the argument for physicians to administer high-efficacy disease-modifying medication earlier for MS patients:
The majority of multiple sclerosis cases, which are the relapsing-remitting form, are caused by a lot of inflammation and nerve damage early on. So we want to prevent inflammation and nerve damage as soon as we can.