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ECTRIMS 2018: Day 3 Update

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Today’s feature

Ask the Experts: Emerging therapies in multiple sclerosis (Part I: mechanisms, therapies and challenges)

Pick of the posters

  • Kapoor R, Sellebjerg F, Hartung H-P et al. Natalizumab reduced serum levels of neurofilament light chain in secondary progressive multiple sclerosis patients from the Phase III ASCEND study. This study evaluated the associations of serum neurofilament light chain (sNfL) and disease activity, disability progression and response to natalizumab treatment in patients with secondary progressive multiple sclerosis (MS) enrolled in the ASCEND study. Similar to previous observations in patients with relapsing-remitting MS, baseline sNfL concentrations in patients with secondary progressive MS in the ASCEND study were associated with baseline disease activity measures and future brain atrophy rates over a 96-week period. Natalizumab reduced sNfL concentrations compared with placebo in patients with secondary progressive MS with or without acute inflammatory activity. According to the researchers, their findings suggest that sNfL might not only reflect inflammation-driven neuro-axonal damage, but also non-inflammatory neurodegeneration in patients with MS.
  • Ontaneda D, Moore A, Bakshi R et al. Risk estimates of progressive multifocal leukoencephalopathy related to fingolimod. The primary objective of this investigation was to estimate the global risk of progressive multifocal leukoencephalopathy (PML) in MS patients taking fingolimod and assess the impact of age and treatment duration using an analytical approach supported by simulation. The investigators concluded that there is evidence that risk of PML increases with cumulative exposure; PML associated with fingolimod is very rate; and the modeled risk of PML remains low even for those starting treatment at an older age or with longer treatment duration.
  • Backer-Koduah P, Brandt AU, Piper SK et al. Vitamin D supplementation in multiple sclerosis: primary efficacy endpoint and safety of a randomized, controlled, double-blind Phase II trial (EVIDIMS). This study aimed at investigating the superiority and safety of high-dose vitamin D supplementation to low dose as an add-on therapy to IFN B-1b in MS in terms of cranial MRI and clinical parameters. Their poster indicated that high-dose supplementation increased serum 25-OH-vitamin D to sufficient levels with no positive effect on the cumulative number of new T2 lesions. Additionally, supplementation with high-dose vitamin D each other day as an add-on therapy to IFN B was safe and tolerable in relapsing-remitting MS patients. Lastly, high-dose supplementation reduced the number of gadolinium-enhancing lesion count (p = 0.016) and gadolinium-enhancing lesion volume (p = 0.008) compared with the low-dose arm.
  • Kuhle J, Daizadeh N, Barro C et al. Alemtuzumab reduces serum neurofilament light chain levels in relapsing-remitting multiple sclerosis patients from the CARE-MS I study. This study wanted to investigate the relationship between baseline sNfL levels and baseline MRI lesion burden, and to determine the effects of alemtuzumab on sNfL levels over 2 years in patients from the CARE-MS I study. Baseline sNfL levels correlated strongly with baseline gadolinium-enhancing lesion count and T2 hyperintense lesion volume, consistent with previously published work. Baseline sNfL levels were weakly associated with brain volume loss over 8 years; notably, robust brain volume loss reductions were observed following alemtuzumab in patients with baseline sNfL levels above or below the median. Lastly, initiation of alemtuzumab was associated with a significant sNfL reduction that was maintained over 2 years (overall, 92% of patients had reduced sNfL post-alemtuzumab; of those, 77% had a reduction greater than or equal to 50%).

Picture of the day

Meet our Editor, Sharon Salt! She’s pictured here working really hard on this round-up. 

Today at our booth

Today was our last day exhibiting at ECTRIMS and we’ve loved every minute of it. Our most popular giveaways at the conference were our USBs and tote bags – we’re glad you all liked them! If you didn’t manage to catch us at the conference then you can still sign up to be a member of Neuro Central for free by clicking the link here. We look forward to seeing everyone at ECTRIMS 2019 in Stockholm, Sweden!

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