Clinical Research For Multiple Sclerosis

Clinical research studies are bringing us closer to finding a cure for Multiple sclerosis. This is the motto of 2018 World MS Day. Its agenda under the hashtag #bringinguscloser is very similar to FindMeCure’s mission – building a bridge between patients and the world of medical research.

Naturally, we decided to take part in the campaign by spreading the knowledge about clinical trials in MS and how far we’ve already made it in terms of advancing treatments.

So, what is going on in the medical world? What kinds of treatments are being tested and what results are they showing so far?

Rebooting the immune system

As you know, in MS the immune system mistakenly attacks the protective myelin surrounding neuron fibers, which exposes said fibers to damage and eventually degeneration. A somewhat radical approach to treating MS is ‘restarting’ the immune system itself in order to stop this process.

What such a restart entails is, to put it in a nutshell, destroying the immune system using chemotherapy and then introducing stem cells previously collected from the person’s own blood or bone marrow. The newly introduced cells can then over time reconstruct the immune system.

The experimental procedure is known as HSCT which stands for Hematopoietic Stem Cell Transplantation, hematopoietic being the stem cells which can produce new blood cells. As ‘experimental’ suggests, this therapy has not yet been approved by the FDA but it shows a lot of promise and clinical trials are being conducted to determine the most efficient procedure and any potential side effects or risks. One such Canadian trial for example suggests that a hospital stay can last for up to 160 days, while the immune system rebuilds itself.

As for effectiveness, or in other words – to answer the question ‘is it worth it?’, a clinical trial conducted in Italy reports a significant deceleration of disease activity and progression. 83% of participants had not shown any progression within 2 years after the procedure.

Mesenchymal stem cells in MS

It’s a very similar approach to what HSCT does, except it doesn’t require the chemical destruction of the immune system.

Mesenchymal stem cells are extracted from the person’s bone marrow and then multiplied in a lab and re-introduced into the body. The goal is suppression of the unwanted immune system response (the destruction of myelin) and an increase in tissue repair.

Clinical trials are trying to determine the best way such a procedure can be conducted – what the optimal number of mesenchymal stem cells is, what’s the best delivery method and so on. The most recently published results are from a clinical trial in phase I in which mesenchymal stem cells were used to used to derive another type of stem cells – ‘neural progenitor cells’.

Though the main purpose of the trial was to assess the safety of the procedure (participants reported minor adverse effects), the treatment also showed a lot of promise in terms of efficacy^[1]. A follow-up trial, phase II, is being planned.

If you’re looking for a recruiting trial, you can try this phase II trial which is looking into the optimal way to administer the mesenchymal stem cells or you can check this international one, phase II, which is testing the benefits of the treatment, or in other words, is testing mesenchymal stem cells against placebo.

What more?

Not as original compared to the other therapies discussed here, new drugs are also being investigated. The purpose of such drugs is either to protect the myelin ‘covers’ or help them recover after an attack. Other possible tactics are intervening in the process of inflammation itself or preventing immune-system cells from crossing the blood-brain barrier (a literal barrier which separates the brain from the circulating blood).

To name a few of the drugs which passed phase II of clinical trials and show a lot of promise in the prevention of new MS lesions: rituximab, ocrelizumab, daclizumab, cladribine, laquinimod, teriflunamide, and fumaric acid. So, now you can check specifically for them in our database.

As you can see, clinical research has already brought us closer to finding better treatments for MS. And though, medical professionals haven’t yet found what causes the disease or how to cure it for good, new options are available that allow a better chance at a fulfilling life. Clinical trials are part of the process which brings these options to the people who need them.

Article by Nelly Katsarova

^[1] https://www.nationalmssociety.org/About-the-Society/News/Results-Published-of-Phase-I-Mesenchymal-Stem-Cell