ECTRIMS/2015
The biggest news from the recent ECTRIMS conference in Spain was the data about the new drug called ocrelizumab. This is a type of drug know as a B-cell depleter, meaning that it targets B-cell lymphocytes. Many of our existing treatments target T-cells, a different type of lymphocyte, so this is a fairly dramatic new step. In general, B-cells fight infection by producing antibodies, while T-cells attack invaders, bacteria, viruses, etc, directly.
The new drug is similar to a drug called rituximab, (Rituxan), which seems to be effective for MS but which is not FDA approved for MS, for reasons which are financial and political, not medical.
The new drug is a monoclonal antibody, and is given intravenously every 6 months. So far the side effects have been very mild. PML has been very rare with rituximab, and no cases have been seen so far with ocrelizumab. Most importantly it seems very effective at reducing relapses and new MRI activity, much better than interferon. It also seems to slow the progression of progressive MS, which is very exciting since the only other drug shown to do that is novantrone, which has serious side effects.
So will ocrelizumab be the next big thing? it’s possible, but obviously it’s early days, but stay tuned. Genentech plans to submit it to the FDA for approval in early 2016, so if all goes well it could be approved as early as the end of 2016.
Other research showed that most patients, about 70%, treated with alemtuzumab (Lemtrada) had no further relapses or worsening of disability for up to 4 years after treatment, which is certainly encouraging.
Finally there was a very interesting study with minocycline, an antibiotic with a good established safety record, showing that it slowed the progression of patients with the very early, CIS form of MS to full blown MS. We shall see.
