Neurology AdvisorUnlocking the Future of Multiple Sclerosis Treatment: Highlights From ECTRIMS-ACTRIMS 2023

Advancing Multiple Sclerosis Treatment: A New Era of Therapeutic Strategies and Implications

The 2023 ECTRIMS-ACTRIMS meeting in Milan unveiled critical advancements in multiple sclerosis (MS) treatment, marking a significant shift in therapeutic strategies. This comprehensive overview focuses on the latest findings from pivotal studies, offering insights into the evolving landscape of MS management. Key highlights include the transition from intravenous to subcutaneous treatments, the emergence of Bruton’s tyrosine kinase (BTK) inhibitors, and comparative studies of novel MS therapies, all pointing towards more personalized and effective treatment options for patients.

Key Points

• OLIKOS Study: Transition from IV to SC anti-CD20 therapies, like ofatumumab, showing sustained efficacy and safety, suggesting benefits such as improved patient comfort and reduced clinic time.
• Ofatumumab: Monthly SC administration offers convenience, potentially enhancing patient adherence and outcomes; compared favorably with other anti-CD20 therapies like ocrelizumab and ublituximab.
• BTK Inhibitors: Evobrutinib and others targeting the innate immune system and CNS, offering new treatment possibilities for both relapsing and progressive MS.
• MIRANTIBUS Trial: Divozilimab shows higher effectiveness than teriflunomide in reducing relapse rates in relapsing MS, indicating a promising new treatment option.
• KYRIOS Study: MS patients on ofatumumab therapy demonstrate specific immune responses to SARS-CoV-2 mRNA vaccines, including for initial and booster doses.
• BTK Mechanism: Targets macrophages and microglia within the CNS, offering potential for treating progressive MS forms; BTK inhibitors preserve B cell functionality.
• Evobrutinib: A promising BTK inhibitor, currently in phase 3 trials for relapsing MS, could expand available treatment options.
• Treatment Strategy Trends: Growing preference for individualized therapy sequences and exploration of treatments effective for both relapsing and progressive MS forms.

In addition to its convenient dosing, the subcutaneous administration of ofatumumab offers patients flexibility and potentially reduces the need for frequent clinic visits, which can be especially valuable for those with mobility challenges or in remote areas.
– Fred D. Lublin, MD, Icahn School of Medicine at Mount Sinai, New York City, NY

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