02 November 2012

Multiple sclerosis can be treated with an anti-cancer drug

The cancer drug turned out to be the most effective remedy for multiple sclerosis

Copper newsThe third phase of large-scale clinical trials of the drug alemtuzumab, which lasted for a total of four years, confirmed its greater effectiveness in alleviating the condition of patients with relapsing-remitting multiple sclerosis (MS) compared with interferon beta–1a (Rebif), a drug used as a standard for this disease.

Multiple sclerosis is a chronic autoimmune disease that usually occurs in young and middle age (from 15 to 40 years). In this disease, the cells of the body's immune system destroy the myelin sheaths of nerve fibers, mistaking them for a foreign agent. In this regard, foci of demyelination (plaques) appear in the brain and spinal cord, preventing the passage of nerve impulses, and patients develop and gradually progress disorders of sensitivity and coordination of movements.

Reports on two parallel alemtuzumab testing cycles conducted by researchers from the University of Cambridge (UK) were published on November 1 in The Lancet.

Alemtuzumab is a licensed drug that has been used for the treatment of chronic lymphocytic leukemia and T–cell lymphoma for several decades. It contains monoclonal humanized antibodies binding to CD52 glycoprotein, which is expressed on the surface of normal and malignant B and T lymphocytes, natural killers, monocytes and macrophages.

However, over time, it was noticed that alemtuzumab also has a positive effect on the condition of MS patients, which was confirmed during the first clinical trials, also conducted by specialists from Cambridge, which ended in 2008. Scientists believe that this phenomenon is based on the fact that alemtuzumab selectively destroys mature lymphocytes involved in the immune response in MS without affecting their precursors in the bone marrow. After that, the population of immune cells is restored, but no longer contains lymphocytes attacking myelin sheaths, which resembles a kind of "reset" of the immune system.

During the last phase of clinical trials designed to definitively confirm the effectiveness of alemtuzumab in MS, in one case (Cohen et al., Alemtuzumab versus interferon beta 1a as first-line treatment for patients with relapsing-remitting multiple sclerosis: a randomized controlled phase 3 trial), the effect of the drug was compared with Rebif in patients at an early stage diseases that had not previously received any treatment, and in the second case – in those for whom the treatment did not help (Coles et al., Alemtuzumab for patients with relapsing multiple sclerosis after disease-modifying therapy: a randomized controlled phase 3 trial).

In both cases, alemtuzumab demonstrated twice as much effectiveness in preventing relapses of the disease as Rebif. In addition, the general condition of patients with advanced stage of MS after two years of taking alemtuzumab improved compared to the beginning of treatment. According to the head of research, Dr. Alasdair Coles, none of the new MS drugs that have appeared on the market in recent years has shown such good results in comparison with Rebif as alemtuzumab.

At the same time, in an interview with the BBC (Multiple sclerosis: New drug 'most effective') Coles stressed that alemtuzumab is simply the most effective drug for patients with relapsing–remitting MS of all currently existing, but by no means a panacea. In addition, clinical trials have revealed quite serious side effects of alemtuzumab. We are talking about various infectious complications, allergic reactions and autoimmune diseases, mainly related to thyroid dysfunction, as well as immune thrombocytopenia.

According to Coles, alemtuzumab can mainly be used as an alternative drug for those patients who have not been helped by standard treatment, and in more rare cases – as the first and main drug. In addition, Coles stressed, alemtuzumab is not effective in progressive MS.

The manufacturer of alemtuzumab, Genzyme (a division of the French pharmaceutical giant Sanofi), in August recalled the drug from the US and EU markets in order to obtain a license for its use as a remedy for MS from the relevant regulators. As noted in an editorial in The Lancet dedicated to the completion of clinical trials of Alemtuzumab (Alemtuzumab for multiple sclerosis), after licensing, the price of the drug may rise and become too high for most patients and healthcare systems.

Three new MS medications have been proposed recently. In 2010, the drug fingolimod (trade name "Gilenia") produced by Novartis was released to the US market. On September 12, 2012, American regulatory authorities approved the drug teriflunomide, produced by Sanofi under the trade name Aubagio. The European regulator is expected to make a decision on teriflunomide in the first quarter of 2013. On September 21, 2012, two international groups of specialists reported on the successful results of the third, last, phase of clinical trials as a remedy for MS of the drug BG-12 (dimethyl fumarate), commonly used in the treatment of psoriasis.

Portal "Eternal youth" http://vechnayamolodost.ru02.11.2012

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