MSMilan 2023 Highlights Podcast

In this episode (17:40), Medicom’s correspondent covers 6 presentations from the MSMilan 2023 (9th Joint ECTRIMS-ACTRIMS Meeting), 11–13 October, held in Milan, Italy.
The topics discussed are:

1. Fenebrutinib shows rapid reduction of new Gd+ T1 lesions
   Fenebrutinib penetrates the cerebrospinal fluid (CSF) at sufficient enough levels to reduce activation of B-cells and microglia in vitro. These early findings from the ongoing phase 2 study FENopta suggest that this new drug may impact mechanisms underlying chronic progressive disease-biology in MS. The study met its primary endpoint, with a 69% reduction in the number of new T1-lesions in weeks 4-12..
2. Early initiation of highly active treatment associated with a lower risk of SPMS
   A French, retrospective, multicentric register study evaluated the long-term impact of the early use of high-efficacy therapy (HET) on the occurrence of secondary progressive MS (SPMS). After 10 years, only 8.0% of patients treated early with HET converted to SPMS. This percentage is lower than would be expected when looking at the known natural history of MS, making the authors advocate for early introduction of HET in younger patients.
3. Smouldering inflammation detectable even in the earliest stages of MS
   It may be that chronic lesion-associated smouldering inflammation is more pronounced in the later phase of the disease, but it can be detected from the earliest stages of MS, according to Finnish research. The prevalence of paramagnetic lesions (PRLs) was highest in patients with the shortest disease duration.
4. Positive phase 2 results for first-in-class anti-CD40L antibody
   Efficacy and safety data at week 24 from the ongoing open-label part of the frexalimab phase 2 trial in relapsing MS were promising. This first-in-class anti-CD40L antibody was well tolerated and continued to demonstrate a marked reduction of new MRI lesions. Phase 3 trials for frexalimab are already in preparation.
5. Prioritising highly-effective therapies in children with MS
   Highly-effective therapies (HET) as a first-line option in paediatric-onset MS (POMS) results in sustained reduction of clinical and radiological disease activity over 5 years, compared with first choosing moderately-effective therapies (MET). The results of their study prompt the French authors to advocate HET as first choice in children with MS.
6. Switching from rituximab to C5 complement inhibitors is safe in AQP4+ NMOSD
   Many patients with anti-aquaporin-4 antibody-positive neuromyelitis optica spectrum disorder (AQP4+ NMOSD) used rituximab prior to transitioning to C5 complement inhibitors (C5ITs). In these patients, safety outcomes in the PREVENT and CHAMPION-NMOSD studies were not different from patients who had not received prior rituximab. This is important to know for patients and caregivers when considering a switch.

Enjoy listening!
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Posted on 31 October, 202317 January, 2024