b'Medicine & ResearchRX UpdateMultiple Sclerosis DruBs in the PipelineSeveral treatments show promise as future optionsBy Ellen Whipple, Pharm.D.Thetimelineofmultiplesclerosisresearch specictypeofcancer.Thoughthedrugworksdatesbacktothemid-1800s,atwhichpoint similarlytoocrelizumab,ofatumumabwouldscientistswerejustbeginningtounderstand beadministeredbymonthlysubcutaneoustheroleofmyelininthebrain.Overtheyears, injectionsratherthanthroughinfusions.Twomanymedicationswereanalyzedinclinical phaseIIIclinicaltrialshaveshowedpromisingtrialsandledtotherapyapprovalsforboth results,andevenreportedthatrelapseratestreatmentsoftheunderlyingdiseaseandfor weredecreasedby50percentwhencomparedimprovingrelapserates.TheFDAapproved toteriunomide.Novartisiscurrentlypursuingtherstoraldisease-modifyingtreatmentfor FDAapprovalforuseinrelapsingMS.relapsingMSin2010,andtherstmedicationforuseinchildrenin2018.Thereareavariety UblituximabisanothermonoclonalantibodyofmedicationsintheMSpipelinetoday,with thatisbeingstudiedforuseinrelapsingMS.severaldierentmechanismsofactionand PhaseIIresearchhasalreadyproventhatthearangeofclinicaltrialresults. medicationissafe,andnowphaseIIItrialsInrecentyears,therehavebeenasignicant areunderwaytodetermineitsecacy.Thoughnumberofmedicationsapprovedthatare similartootherexistingmedications,thecategorizedasmonoclonalantibodies.A manufacturerishopefulthatthismedicationmonoclonalantibodymimicsanaturally willbeabletoprovidethesamebenetasoccurringantibody,andwillusetheindividuals ocrelizumabeitheratalowerdoseoroveraownimmunesystemtoghtothedisease. shorterinfusiontime.FortreatmentofMS,monoclonalantibodies Ofaslightlydierentmechanismthanhavequicklygrowninpopularitybecauseof thepreviouslymentionedmonoclonalanti-theirabilitytospecicallytargetthediseasewith bodies,temelimabtargetsaspecicproteinthatrelativelyhighecacy.Severalmonoclonal isbelievedtohavearoleinthedevelopmentantibodieshavebeenapprovedtodatefor ofMS.MSiscausedinpartbyincreasedtreatmentofMS,andtheseincludenatalizumab, inammationinthecentralnervoussystem,alemtuzumab,andocrelizumab. andtheintendedmechanismofactionforAnother medication, ofatumumab, has temelimabwouldbetorelievethisinammationactuallybeenonthemarketsuccessfullyfor topreventdiseaseprogression.ThemedicationseveralyearsunderthebrandnameArzerra, shouldworktohelpxthedamagetothewhichisFDA-approvedfortreatmentofa myelinsheaththatoccursinMS.msfocusmagazine.org 56'