Multiple Sclerosis News TodayMRI Method Detects Myelin Repair with Over-the-counter Antihistamine

The medical community is observing a significant breakthrough as clemastine, an over-the-counter antihistamine, shows potential to repair myelin, a protective coating on nerve fibers that gets damaged in multiple sclerosis (MS), based on an analysis of MRI data from the ReBUILD clinical trial.

Key Points:

• Clemastine, an over-the-counter antihistamine, demonstrated an ability to repair myelin in multiple sclerosis (MS) patients, as shown by MRI data from the ReBUILD clinical trial.
• This is the first example of brain repair being documented on MRI for a chronic neurological condition, according to Ari Green, MD, study co-lead.
• The study provides the first direct, biologically validated, imaging-based evidence of myelin repair induced by clemastine, paving the way for future remyelinating therapies.
• No approved therapies exist that can restore the myelin sheath; the development of such therapies is inhibited by the lack of validated imaging methods showing restoration.

Additional Points:

• Myelin water fraction (MWF), the ratio of water trapped within the thin layers of myelin to the total water content in brain tissue, has been used as a measure of myelin repair.
• The study utilized MRI data from 50 adult patients from the now-complete Phase 2 ReBUILD trial (NCT02040298).
• Treatment with clemastine demonstrated improved speeds of electrical signals along the optic nerve, suggesting potential for myelin repair.
• Despite its potential, clemastine can be only partially effective at the doses we can use due to side effects like sedation.

Conclusion:

• This groundbreaking study presents the first positive identification of an MRI correlate of therapy-induced remyelination in a clinical trial, positioning the corpus-callosum MWF as a potential standard for future remyelinating therapies.

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