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Retinoid-X receptor agonist promotes remyelination

MS Virtual 2020
In a double-blind, placebo-controlled phase 2a trial, the non-specific retinoid-X receptor agonist bexarotene promoted remyelination in MS patients [1]. Bexarotene was very poorly tolerated and its use in MS is not recommended by the authors. However, they believe that their data support the development of selective retinoid-X receptor gamma agonists. The trial assessed the safety and efficacy of bexarotene, which is licensed for the treatment of cutaneous T cell lymphoma, as a remyelinating therapy in people with relapsing-remitting MS. The 52 randomised participants were aged 18-50 years, had an EDSS score of 6 or less and at least 5 MRI brain lesions, and were stable on dimethyl fumarate for at least 6 months. They were randomised 1:1 to bexarotene 300 mg/m2 or placebo for 6 months. The primary efficacy endpoint was change in magnetisation transfer ratio (MTR) of those lesions with the lowest tissue integrity at baseline, that is those with M...

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