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Interview with Dr. Fred Lublin on INFORMS and other studies
Dr. Claire Riley, assistant professor of neurology in the Neurological Institute, Columbia University, interviews Dr. Fred Lublin, Saunders Family Professor of Neurology and the Director of the Corinne Goldsmith Dickinson Center for Multiple Sclerosis at Mount Sinai Medical Center.
Results of the phase III INFORMS study (fingolimod) trial are discussed. This was a randomized controlled trial in patients with primary progressive MS. There was an 80% response rate after 1 year of treatment. The treatment group had a reduction in the appearance of new lesions over the course of the study. However, the overall results of the trial were negative. Fingolimod was no different than a placebo. Dr. Lublin summarizes that anti-inflammatory agents may not be useful in treating disease that has progressed. The next step might be neuroprotective molecules.
Additionally, there is interest in a new topographical model of MS that could be helpful in predicting the phase of MS progression for individual patients. MS phenotypes area a point in time, the clinical course of an individual patient can change over time. This model is integrating the course of MS over time. Predictive mathematical models would be very useful to clinicians for assessing prognosis.
Other highlights include myelin repair studies that may provide clinicians with treatments that can repair damage from MS instead of just halting progression.
Alemtuzumab was recently approved for use in the US. Alemtuzumab is a very good induction agent, and can knock out lymphocytes. Although, over time disease activity returns. However, there is still some uncertainty surrounding patient selection for this treatment.