1- The 2014 Americas Committee for Treatment and Research in Multiple Sclerosis (ACTRIMS)/European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) meeting, in Boston, Massachusetts witnessed the first presentation of the phase 3 trial data for daclizumab, a new drug for MS. Daclizumab is a monoclonal antibody that went through a placebo-controlled phase 2 study in the past, with positive results. This phase 3 study was a direct head-to-head comparison with interferon beta-1a, the classical treatment for MS, given once a week by intramuscular injection.
This trial’s results were positive. Even though daclizumab was compared head-to-head against an existing, approved treatment, this new monoclonal antibody proved to be superior on all of the main outcome endpoints in terms of preventing relapses; preventing MRI lesions of MS; and even one of the disability metrics, preventing the accumulation of disability. Daclizumab is injected subcutaneously (under the skin) once a month.
2- Preliminary data show that there are at least a couple of different genera of bacteria that are different in the gut of MS patients compared with healthy controls. A bug called Methanobrevibacteriaceae was found to be enriched in the gut of MS patients and seems to have immunoproliferative properties that promote inflammation. Additionally, the population of Butyricimonas bacteria was noted to be low in MS patients compared with healthy controls. This is an interesting result because these bacteria produce butyrate, which is thought to be immunosuppressive, but repeating this study in a larger cohort is needed to ensure the reliability of these observations. So it seems that these experiments initially support thenotion that the gut in MS patients contains bugs that drive inflammation and are low in the types of bacteria that control inflammation. This is consistent with work in rheumatoid arthritis and inflammatory bowel disease.
3- One persistent question that has always puzzled scientists is whether MS begins in the peripheral immune system or in the brain. An enormous progress in the understanding of this disease has been recently underscored, as scientists were able to explain how MS begins in the periphery and moves on from there. This finding may constitute a paradigm shift in how MS pathophysiology is understood and paves the way for future research and the development of new medications.