MS in children is rare, with around 10,000 worldwide estimated to have pediatric-onset multiple sclerosis. Most of these patients have RRMS, and tend to have a higher frequency of relapses and related hospitalizations than their adult counterparts.
“Adequate long-term safety and efficacy data on DMTs [disease-modifying therapies] for the pediatric population are limited, resulting in a shortage of approved MS-specific treatment options in this patient population,” the researchers wrote.
Novartis’ Gilenya (fingolimod) is currently the only DMT approved in both the U.S. and Europe for pediatric MS patients, ages 10 and older. As such, there is an unmet need for long-term clinical data evaluating MS therapies in children and adolescents.
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A newly identified subset of astrocytes cells long thought to be responsible for simply providing nutrition and support to neurons can prevent brain inflammation by promoting the destruction of pro-inflammatory immune T-cells, scientists report.
Their work also found that the anti-inflammatory activity of this astrocyte subpopulation is dependent on interferon-gamma a molecule known to control immune and inflammatory responses produced by natural killer (NK) cells, another subset of immune cells.
Interestingly, the production of interferon-gamma by NK cells was seen to be controlled by the gut microbiome, the set of bacteria and other microbes that live in the gastrointestinal tract.
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Multiple sclerosis (MS)-associated inflammation in the cerebral cortex the outermost layer of the brain that is involved in cognitive function prompts the destruction of neural connections by specific immune cells, according to a study in a mouse model of MS.
These immune cells targeted dendritic spines (nerve cell communication structures) containing abnormally high levels of calcium a dysregulation previously associated with nerve fiber degeneration in MS.
Importantly, blocking the activation of these immune cells, called phagocytes, successfully prevented the loss of cerebral cortex synapses (sites of neural communication) in the mice, highlighting that similar approaches may help prevent disease progression in people with MS.
Age Found to Be Main Driver of MS Disability, Patient Therapy Response 3.6 (44)
Age is a main driver of disability in multiple sclerosis (MS) and has a key influence on patients’ therapeutic responses to Tecfidera (dimethyl fumarate) and Tysabri (natalizumab), a study showed.
Given those findings, age should be considered in the risk/benefit assessment that’s used in the decision-making process for choosing MS treatments, the researchers suggested.
The study, “
A patient’s age has a key role in modeling the immune system and therefore may affect both MS progression and an individual’s response to treatment. However, most clinical trials undervalue age as a major contributor to disability in MS patients, researchers say.
PPMS and SPMS are disease subtypes grouped under the umbrella of “progressive MS.” However, the two disease forms have distinct development and progression, and can respond differently to treatment.
Ibudilast is being developed by MediciNova, under license from Kyorin Pharmaceutical, as a potential oral MS therapy. It has been approved in Japan to treat asthma and stroke since 1989.
Previous results from the SPRINT-MS Phase 2b clinical trial (NCT01982942) in progressive MS patients 134 with PPMS and 121 with SPMS showed significant overall reductions in the rate of brain atrophy progression in patients treated with ibudilast (up to 100 mg total each day) compared with those in both groups given a placebo for 96 weeks (about two years).