b"Doctors NotesThe MS News column includes analysis from Ben Thrower, M.D., MS Focus senior medical advisor. He draws from the top news stories of the quarter and explains what the news means to you, the person with MS. Christine Willis, MLIS, AHIP, is the Clinical Information Librarian at Children's Healthcare of Atlanta, Egleston Hospital.Tolebrutinib slows disability indisability progression compared to the 37.2 nonrelapsing secondary progressive MSpercent of the placebo group.HERCULES trial results, presented byThis is exciting in that tolebrutinib is the researchers from the Mellen Center for Multiplerst therapy to show slowing of disability in Sclerosis at the Cleveland Clinic, in Ohio,nonrelapsing SPMS. Many of us were hoping showed tolebrutinib, a Bruton's tyrosine kinasefor more impressive results. It could be that as inhibitor, slowed disability progression in peoplepatients are on therapy longer, the treatment with nonrelapsing secondary progressive MS.effect will be greater. It signicantly delayed the onset of six-monthResults from two studies of tolebrutinib in conrmed disability progression comparedrelapsing forms of MS were also presented. In to the placebo. The drug also reduced new orthe GEMINI 1 and 2 trials, tolebrutinib was enlarging brain lesions and improved six-monthcompared to teriunomide and was found to conrmed disability. However, there were somebe no more effective in reducing annualized concerns about liver injury and serious siderelapse rates. Tolebrutinib was more effective effects, including two deaths. These results willat slowing disability. guide discussions with regulatory authorities.In recent years, there has been great interest Further trials are ongoing to evaluate tolebrutinibin the concept of smoldering MS as one cause in primary progressive MS. The ndings werefor progression independent of relapse activity. presented at the European Committee forTaking the results of the HERCULES and Treatment and Research in MS 2024 inGEMINI trials, they would suggest tolebrutinib Copenhagen. may affect on this smoldering inflammation Thrower -Tolebrutinib belongs to a class ofbut not as much effect on more obvious investigational oral agents for MS called BTKinammation. inhibitors.SeveralBTKagentsarebeingFDA approves Ocrevus Zunovo testedforbothrelapsingandprogressive forms of MS. At the recent ECTRIMS, studyas subcutaneous injection to treat MSresults were presented for trials in SPMS andGenentech announced FDA approval for relapsing MS. The latter will be discussed below.Ocrevus Zunovo, a subcutaneous injection for The HERCULES study was a phase III trial oftreating relapsing and primary progressive tolebrutinib versus placebo in nonrelapsingMS. It offers patients a quicker, twice-yearly SPMS. Tolebrutinib was shown to slow progressionalternative to the intravenous version, taking of disability by 31 percent compared to thearound 10 minutes to administer. Based on placebo group. In actual numbers, at six months,the Phase III OCARINA II trial, the drug showed 26.9 percent of the tolebrutinib group hadsimilar efficacy to the IV version, reducing 45 msfocusmagazine.org"