Updates and advances in multiple sclerosis neurotherapeutics

Amin, Moein; Hersh, Carrie M.

doi:10.2217/nmt-2021-0058

Cited by 34 publications

(4 citation statements)

References 175 publications

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“…All three increase the risk of infection, which in some cases can be severe. 31,32 Given the high comorbidity of neuropsychiatric symptoms and MS, with some comorbidity precipitated by MS medications, it is important that providers have a low threshold for screening these symptoms and refer patients for treatment as needed. The national MS society recommends early baseline screening for cognitive symptoms with annual (or more frequent) reassessment.…”

Section: Questions For Consultantsmentioning

confidence: 99%

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A Grave Set of Diagnoses: A Case of Mania with Comorbid Autoimmune Thyroiditis Precipitated by Multiple Sclerosis Treatment

Yue,

Shah,

Modzelewski

et al. 2023

Harv Rev Psychiatry

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Section: Questions For Consultantsmentioning

confidence: 99%

“…Ocrelizumab and ublituximab can cause infusion reactions and ofatumumab can cause injection-site reactions. All three increase the risk of infection, which in some cases can be severe 31,32 …”

Section: Questions For Consultantsmentioning

confidence: 99%

A Grave Set of Diagnoses: A Case of Mania with Comorbid Autoimmune Thyroiditis Precipitated by Multiple Sclerosis Treatment

Yue,

Shah,

Modzelewski

et al. 2023

Harv Rev Psychiatry

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“…The cornerstone of MS treatment is disease-modifying drugs. The first to be used, starting in the 1990s, were preparations of interferon beta and glatiramer acetate [ 4 , 16 ]. Over the years, as knowledge has advanced regarding the pathophysiological mechanisms underlying the disease, new molecules have also been investigated for therapeutic purposes.…”

Section: Introductionmentioning

confidence: 99%

Dietary Polyphenols, Microbiome, and Multiple Sclerosis: From Molecular Anti-Inflammatory and Neuroprotective Mechanisms to Clinical Evidence

Rosa

Lonardo

Cacciapuoti

et al. 2023

IJMS

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Multiple sclerosis (MS) is a multifactorial, immune-mediated disease caused by complex gene-environment interactions. Dietary factors modulating the inflammatory status through the control of the metabolic and inflammatory pathways and the composition of commensal gut microbiota, are among the main environmental factors involved in the pathogenesis of MS. There is no etiological therapy for MS and the drugs currently used, often accompanied by major side effects, are represented by immunomodulatory substances capable of modifying the course of the disease. For this reason, nowadays, more attention is paid to alternative therapies with natural substances with anti-inflammatory and antioxidant effects, as adjuvants of classical therapies. Among natural substances with beneficial effects on human health, polyphenols are assuming an increasing interest due to their powerful antioxidant, anti-inflammatory, and neuroprotective effects. Beneficial properties of polyphenols on the CNS are achieved through direct effects depending on their ability to cross the blood-brain barrier and indirect effects exerted in part via interaction with the microbiota. The aim of this review is to examine the literature about the molecular mechanism underlying the protective effects of polyphenols in MS achieved by experiments conducted in vitro and in animal models of the disease. Significant data have been accumulated for resveratrol, curcumin, luteolin, quercetin, and hydroxytyrosol, and therefore we will focus on the results obtained with these polyphenols. Clinical evidence for the use of polyphenols as adjuvant therapy in MS is restricted to a smaller number of substances, mainly curcumin and epigallocatechin gallate. In the last part of the review, a clinical trial studying the effects of these polyphenols in MS patients will also be revised.

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“…4 Alemtuzumab (Lemtrada ® ; Sanofi, Cambridge, MA) is a high-efficacy DMT for RRMS that targets CD52-expressing B and T cells for depletion, enabling subsequent repopulation of B and T cells with lower pathogenicity. 5,6 Compared with most other DMTs for RRMS that require life-long dosing, 7 treatment with alemtuzumab requires brief and infrequent dosing, with two courses administered 12 months apart and additional courses provided only upon evidence of disease activity. 8 The phase III CARE-MS trials compared the efficacy and safety of IV alemtuzumab versus subcutaneous interferon (IFN) beta-1a (SC IFNB-1a) over 2 years in treatmentnaïve participants with RRMS (CARE-MS I; NCT00530348) 9 and participants with inadequate response to prior therapy (CARE-MS II; NCT00548405).…”

Section: Introductionmentioning

confidence: 99%

Safety and efficacy with alemtuzumab over 13 years in relapsing-remitting multiple sclerosis: final results from the open-label TOPAZ study

Coles,

Achiron,

Traboulsee

et al. 2023

Ther Adv Neurol Disord

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Background and objectives: Alemtuzumab demonstrated superior efficacy versus subcutaneous interferon (IFN) beta-1a in participants with relapsing-remitting multiple sclerosis in the 2-year CARE-MS I and II trials. Efficacy was maintained in the 4-year CARE-MS extension, during which alemtuzumab-treated participants (‘alemtuzumab-only’) could receive additional courses upon disease activity, and IFN-treated participants switched to alemtuzumab (‘IFN-alemtuzumab’). Participants who completed the CARE-MS extension could enroll in the open-label TOPAZ study which assessed safety and efficacy for 5–7 years (11–13 years after alemtuzumab/IFN initiation). Methods: Participants received additional alemtuzumab courses as needed. Assessments included adverse events (AEs; primary outcome), annualized relapse rate (ARR), 6-month confirmed disability worsening [CDW; ⩾1.0-point Expanded Disability Status Scale (EDSS) score increase or ⩾1.5 if baseline EDSS = 0], and 6-month confirmed disease improvement [CDI; >1.0-point EDSS decrease (baseline score ⩾2.0)]. Results: 43.5% of alemtuzumab-only participants from CARE-MS II and 54.2% from CARE-MS I received no additional alemtuzumab courses; 30.0% and 20.9%, respectively, received one additional course (the median). Incidences of AEs, including thyroid AEs and infections, declined over time. The safety profile of alemtuzumab was similar for participants who received zero, one, or two additional courses. For CARE-MS II participants, who had inadequate response to previous treatment, ARR remained low during Years 3–13 for the alemtuzumab-only [0.17; 95% confidence interval (CI) 0.15–0.20] and IFN-alemtuzumab (0.14; 0.11–0.17) groups. At Year 11, the proportions of participants who were either free from CDW or who had CDI were higher in the alemtuzumab-only group (58% and 49%, respectively) than in the IFN-alemtuzumab group (51% and 37%). For CARE-MS I participants, who were previously treatment-naïve, clinical outcomes remained improved, and no between-group differences were apparent. Conclusion: Safety risks associated with alemtuzumab treatment declined over time. Clinical benefits were maintained up to 11–13 years, and most participants did not require more than one additional course. Clinicaltrials.gov identifiers: NCT00530348; NCT00548405; NCT00930553; NCT02255656

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Updates and advances in multiple sclerosis neurotherapeutics

Cited by 34 publications

References 175 publications

A Grave Set of Diagnoses: A Case of Mania with Comorbid Autoimmune Thyroiditis Precipitated by Multiple Sclerosis Treatment

A Grave Set of Diagnoses: A Case of Mania with Comorbid Autoimmune Thyroiditis Precipitated by Multiple Sclerosis Treatment

Dietary Polyphenols, Microbiome, and Multiple Sclerosis: From Molecular Anti-Inflammatory and Neuroprotective Mechanisms to Clinical Evidence

Safety and efficacy with alemtuzumab over 13 years in relapsing-remitting multiple sclerosis: final results from the open-label TOPAZ study

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