b'Medicine & Researchcomparing pre- and post-treatment based onFDA approves new drug, the frequency of voiding and urgency. ThereBriumvi, for RMSwere statistically signicant improvements ofUblituximab-xiiy is the first anti-CD20 all parameters. The limitations of this study aremonoclonal antibody approved for individuals that no females were included, inquiries aboutwith RMS that can be administered as a 1-hour uid intake were not recorded, nor were sexualintravenous infusion after the starting dose. behaviors, therefore further research is neededULTIMATE1and2aredouble-blinded, but the treatment shows promise. The researchparallel-group, randomized clinical trials that was published in the journal Multiple sclerosishave identical designs. The studies included and related disorders.individuals with RMS who were treated for Thrower -Bladder dysfunction is a common96 weeks. The two trials had a total of 1094 andbothersomesymptomseeninpeopleindividuals from across 10 countries. with MS. Some deal with a small overactiveParticipants were randomized to receive bladder with urinary frequency, urgency, andeither ublituximab-xii, as an infusion of 150 mg incontinence symptoms. This type of bladderin four hours, then 450 mg in one hour two dysfunction is referred to as detrusor overactiveweeks after the rst infusion, and then 450 mg bladder. Others deal with an underactive bladderevery 24 weeks in one hour, or teriunomide, that empties poorly. For those living with anan active comparator, which was given orally as overactive bladder, we traditionally use orala 14-mg daily dose with an intravenous placebo medicationstolessenthesymptoms.Foronthesamescheduleasublituximab-xii. some,thesemedicationsmayhaveunac- Outcomes showed a lower rate of worsening ceptable side effects or be ineffective. This study looks at a new method fordisability; however, infusion-related reactions managing an overactive bladder throughwere common. Additional trials comparing posterior tibial nerve stimulation. PTNS is acurrent treatments to Briumvi are required for non-surgical procedure that is done in the office.additional evidence of efficacy. The ndings A very thin needle, similar to an acupuncturewere published in the The New England journal needle,isplacedabovetheankle whereaof medicine. special nerve called the tibial nerve is stimulated,Thrower -Theres a new kid on the block. which causes stimulation of the nerves aroundBriumvi(ublituximab)isanewanti-CD20 the bladder leading to the brain. The nervemonoclonal antibody approved for relapsing stimulation leads to decreased urgency andforms of MS. It is most similar to Ocrevus urination. At each stimulation session, the needle(ocrelizumab). These two drugs have similar is attached to a small device that sends mildmechanisms of action and are both administered electricalpulsesthroughthetibialnerve.as twice-yearly infusions. The appeal to Briumvi These pulses help block the nerve signals thatcould be its faster infusion time (one hour) are causing the bladder to be overactive. Eachand potential lower cost. B-cell therapies such treatment takes 30 minutes. Patients receiveas Ocrevus, Kesimpta, Briumvi, and rituximab weekly treatments for 12 weeks. After theare effective therapies for relapsing forms of first 12 sessions, patients typically only needMS. Health insurance carriers frequently play treatment once a month. However, there area large role in which therapy a person with some patients that can go several monthsMS ends up using. We will have to wait and between sessions while still maintainingsee how insurance carriers look at this new bladder control.addition to the MS therapy playing eld.msfocusmagazine.org 46'